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Organization
PROVIDENCE HEALTH & SERVICES MT
Active
Organization
PROVIDENCE HEALTH & SERVICES MT
Active
Parent organization
PROVIDENCE HEALTH & SERVICES
Other names
PROVIDENCE MEDICAL GROUP MONTANA, PMG MT Inpatient Rehab
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
601 W SPRUCE ST STE J, MISSOULA, MT 59802-4047
(406) 327-3350
Mailing address
PO BOX 31001 - 4114, PASADENA, CA 91110-4114
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
03/06/2009
Last updated
05/07/2025
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