PROVIDENCE HEALTH & SERVICES MT

MISSOULA, MT
NPI1730325440
Doing Business AsPMG MT MONTANA INTERNAL MED
Entity TypeOrganization
Authorized ContactKIRK BODLOVIC
CFO
406-327-1918
Organization Subpart ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: MT  0411866)
Enumeration Date2008-12-30
Last Update Date2013-11-22
Business Address
PROVIDENCE HEALTH & SERVICES MT
2819 GREAT NORTHERN LOOP SUITE 200
MISSOULA, MT 59808-1750
Phone number: 406-543-1197
Mailing Address
PROVIDENCE HEALTH & SERVICES MT
PO BOX 12
LIBERTY LAKE, WA 99019-0012
Phone number: 406-327-1918