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Organization
COUNTRY HOME ESTATE, INC
Active
Organization
COUNTRY HOME ESTATE, INC
Active
Other names
None
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY LYNN NEWMAN (PRESIDENT)
(406) 542-1889
Entity
Organization
Contact information
Practice address
1704 S RESERVE ST, MISSOULA, MT 59801-4752
(406) 542-1889
(406) 549-6848
Mailing address
1704 S RESERVE ST, MISSOULA, MT 59801-4752
(406) 542-1889
(406) 549-6848
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
11069
MT
Other
Enumeration date
04/19/2007
Last updated
09/24/2007
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