| Providence Health & Services Mt | |
|
500 W Broadway St Missoula MT 59802-4008 | |
| (406) 329-5630 | |
| (406) 329-5693 |
| Full Name | Providence Health & Services Mt |
|---|---|
| Speciality | Family Medicine |
| Location | 500 W Broadway St, Missoula, Montana |
| Authorized Official Name and Position | Jeff Fee (CEO) |
| Authorized Official Contact | 4063295630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Health & Services Mt Po Box 12 Liberty Lake WA 99019-0012 Ph: (406) 327-1918 | Providence Health & Services Mt 500 W Broadway St Missoula MT 59802-4008 Ph: (406) 329-5630 |
| NPI Number | 1679868079 |
|---|---|
| Provider Enumeration Date | 06/14/2011 |
| Last Update Date | 02/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679868079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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