Organization
MONIDA HEALTHCARE NETWORK RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE WIEST (CONTROLLER)
(406) 829-2380
Entity
Organization
Contact information
Practice address
1200 S RESERVE ST STE H, MISSOULA, MT 59801-3107
(406) 829-2380
Mailing address
1200 S RESERVE ST STE H, MISSOULA, MT 59801-3107
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
04/14/2022
Last updated
04/26/2022
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