| NPI | 1063653897 |
|---|---|
| Doing Business As | PMG MT SPINE & PAIN |
| Doing Business As | PROVIDENCE MEDICAL GROUP MONTANA |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollment 425-358-9786 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2025-05-06 |