| NPI | 1316605637 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP MONTANA |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Dir Reimb Reg Strat/Asst Sec Enroll 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2021-12-03 |
| Last Update Date | 2024-02-14 |