Organization
WELLCARE IME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERE L KOLSTAD (MANAGER)
(406) 926-6950
Entity
Organization
Contact information
Practice address
2825 FORT MISSOULA RD, COMMUNITY BLDG 1, SUITE 101, MISSOULA, MT 59804-7420
(406) 926-6950
(406) 926-6951
Mailing address
2825 FORT MISSOULA RD, COMMUNITY BLDG 1, SUITE 101, MISSOULA, MT 59804-7420
(406) 926-6950
(406) 926-6951
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/16/2016
Last updated
11/16/2016
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