Individual
EDWIN BANGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2205 OXFORD ST, MISSOULA, MT 59801-7936
(406) 549-5127
(406) 721-8117
Mailing address
2205 OXFORD ST, MISSOULA, MT 59801-7936
(406) 549-5127
(406) 721-8117
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2615
MT
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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