| NPI | 1093815243 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SCHOLLS |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Sec For Enrollment/Dir Reimb 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2021-06-17 |