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Individual

JENNIFER LYNN GOULDSBERRY-WELLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACT

Contact information

Practice address
900 S HIGGINS AVE, MISSOULA, MT 59801-4100
(406) 728-2400
Mailing address
1719 S 12TH ST W, APT. B, MISSOULA, MT 59801-4821
(406) 239-6181

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
05/03/2007
Last updated
07/08/2007
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