Organization
PROVIDENCE HEALTH & SERVICES MT
Active
Other names
PROVIDENCE MEDICAL GROUP MONTANA, PMG WMT Florence Family Med
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
5549 OLD HWY 93, FLORENCE, MT 59833-6545
(406) 273-4923
Mailing address
PO BOX 31001 - 4114, PASADENA, CA 91110-4114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/28/2010
Last updated
05/07/2025
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