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Organization

BIRTH CENTER FACILITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LYNN D MONTGOMERY M.D. (SUPERVISING PHYSICIAN)
(406) 549-0978
Entity
Organization

Contact information

Practice address
1211 S RESERVE ST, MISSOULA, MT 59801-3102
(406) 549-0978
Mailing address
1211 S RESERVE ST, MISSOULA, MT 59801-3102
(406) 549-0978

Taxonomy

Speciality
Code
Description
License number
State
261QB0400X
Birthing Clinic/Center
Primary

Other

Enumeration date
08/18/2008
Last updated
08/18/2008
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