PROVIDENCE HEALTH & SERVICES MT

MISSOULA, MT
NPI1336380161
Doing Business AsPMG MT INFECTION DISEASE
Entity TypeOrganization
Authorized ContactDONALD WAYNE ANDERSON
Asst Sec Of Enrollment/Dir Reimb
425-525-5392
Organization Subpart ?Yes
Primary Taxonomy207RI0200X Internal Medicine, Infectious Disease
Enumeration Date2009-03-06
Last Update Date2019-04-01
Business Address
PROVIDENCE HEALTH & SERVICES MT
902 N ORANGE ST
MISSOULA, MT 59802-2928
Phone number: 406-321-1732
Mailing Address
PROVIDENCE HEALTH & SERVICES MT
PO BOX 12
LIBERTY LAKE, WA 99019-0012
Phone number: