Organization
PARKVIEW MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL ANN DUDIK BROSS MD, FAAP (OWNER)
(509) 766-9450
Entity
Organization
Contact information
Practice address
615 S DIVISION ST STE A, MOSES LAKE, WA 98837-3800
(509) 766-9450
Mailing address
615 S DIVISION ST STE A, MOSES LAKE, WA 98837-3800
(509) 766-9450
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
11/20/2017
Last updated
11/20/2017
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