| Pmg Mt Ihi Cpam | |
|
601 W Spruce St Suite A Missoula MT 59802-4057 | |
| (406) 329-2945 | |
| (406) 329-2938 |
| Full Name | Pmg Mt Ihi Cpam |
|---|---|
| Speciality | Clinic/center |
| Location | 601 W Spruce St, Missoula, Montana |
| Authorized Official Name and Position | Donald Wayne Anderson (ASSISTANT SECRETARY ENROLLMENTS) |
| Authorized Official Contact | 4253589786 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pmg Mt Ihi Cpam Po Box 34439 Seattle WA 98124-1439 Ph: (406) 329-2945 | Pmg Mt Ihi Cpam 601 W Spruce St Suite A Missoula MT 59802-4057 Ph: (406) 329-2945 |
| NPI Number | 1598064628 |
|---|---|
| Provider Enumeration Date | 03/15/2011 |
| Last Update Date | 05/05/2025 |
| Certification Date | 05/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598064628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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