| Providence Health & Services Mt | |
|
900 N Orange St Ste 303 Missoula MT 59802-2956 | |
| (406) 327-7337 | |
| (406) 327-7373 |
| Full Name | Providence Health & Services Mt |
|---|---|
| Speciality | Family Medicine |
| Location | 900 N Orange St Ste 303, Missoula, Montana |
| Authorized Official Name and Position | Donald Wayne Anderson (ASST SEC. REGULATORY ENROLLMEN) |
| Authorized Official Contact | 4255255392 |
| 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: (866) 747-2455 | Providence Health & Services Mt 900 N Orange St Ste 303 Missoula MT 59802-2956 Ph: (406) 327-7337 |
| NPI Number | 1730802364 |
|---|---|
| Provider Enumeration Date | 09/20/2022 |
| Last Update Date | 09/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730802364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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