Basic Information
| Provider Information | |||||||||
| NPI: | 1396969267 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOMBS | ||||||||
| FirstName: | RAECHEL | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 N SHERMAN ST | ||||||||
| Address2: | |||||||||
| City: | LESLIE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492519409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5175895071 | ||||||||
| FaxNumber: | 5175895452 | ||||||||
| Practice Location | |||||||||
| Address1: | 130 N SHERMAN ST | ||||||||
| Address2: | |||||||||
| City: | LESLIE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492519409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5175895071 | ||||||||
| FaxNumber: | 5175895452 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2007 | ||||||||
| LastUpdateDate: | 11/25/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QH0002X | 5101016148 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine |
No ID Information.