Organization
MISSION MOUNTAIN MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM KOBERG (OWNER PRESIDENT)
(406) 883-2722
Entity
Organization
Contact information
Practice address
38889 DUBAY ROAD, POLSON, MT 59860
(406) 883-2722
(406) 883-0964
Mailing address
38889 DUBAY ROAD, POLSON, MT 59860
(406) 883-2722
(406) 883-0964
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000810475
—
MT
Enumeration date
01/08/2007
Last updated
09/17/2007
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