PROVIDENCE HEALTH & SERVICES MT

MISSOULA, MT
NPI1730802364
Doing Business AsPMG MT PEDIATRICS
Entity TypeOrganization
Authorized ContactDONALD WAYNE ANDERSON
Asst Sec. Regulatory Enrollmen
425-525-5392
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
Enumeration Date2022-09-20
Last Update Date2022-09-20
Business Address
PROVIDENCE HEALTH & SERVICES MT
900 N ORANGE ST STE 303
MISSOULA, MT 59802-2956
Phone number: 406-327-7337
Mailing Address
PROVIDENCE HEALTH & SERVICES MT
PO BOX 12
LIBERTY LAKE, WA 99019-0012
Phone number: 866-747-2455