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Organization

MTINK

Active
Other names
Green Bean Coffeeshop
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GUY ROBERT SILVERNALE (MANAGER)
(406) 544-7873
Entity
Organization

Contact information

Practice address
2710 BROOKS ST, SUITE 2, MISSOULA, MT 59801-7868
(406) 544-7873
Mailing address
2710 BROOKS ST, SUITE 2, MISSOULA, MT 59801-7868
(406) 544-7873

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary

Other

Enumeration date
03/30/2010
Last updated
03/30/2010
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