Individual
PAULA S COLLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 WEST BROADWAY STREET, SUITE 310, MISSOULA, MT 59802-4012
(406) 728-6520
(406) 329-2936
Mailing address
500 WEST BROADWAY STREET, SUITE 310, MISSOULA, MT 59802-4012
(406) 728-6520
(406) 329-2936
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
355
MT
363AM0700X
Medical Physician Assistant
Primary
MED-PAC-LIC-355
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4302632
—
MT
Enumeration date
09/07/2005
Last updated
12/14/2021
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