Organization
PONDERA MEDICAL CENTER O
Active
Parent organization
PONDERA MEDICAL CENTER
Other names
Pondera Medical Center Optometry
Organization subpart
Yes
Provider details
NPI number
Legal business name
PONDERA MEDICAL CENTER
Authorized official
WAYNE OGBURN (CEO)
(406) 271-3211
Entity
Organization
Contact information
Practice address
403 S DELAWARE ST, CONRAD, MT 59425-2310
(406) 278-5331
Mailing address
PO BOX 758, CONRAD, MT 59425-0758
(406) 278-5331
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
820
MT
Other
Enumeration date
01/11/2012
Last updated
07/25/2013
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