NPI | 1235370065 |
---|---|
Doing Business As | PMG MT WOUND CARE |
Doing Business As | PROVIDENCE MEDICAL GROUP MONTANA |
Entity Type | Organization |
Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollments 425-358-9786 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
Enumeration Date | 2009-03-06 |
Last Update Date | 2025-05-06 |