Individual
KEN BUMKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 CEDAR ST, MISSOULA, MT 59802-3911
(406) 541-4673
Mailing address
2186 AMITY LN, MISSOULA, MT 59804-5107
(406) 239-5380
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-SWLC-LIC-49297
MT
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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