NPI 1063810414

Damien Colvin Powledge, PAC

Practitioner Physician Assistant Missoula, MT

Practice location

Address: 500 W Broadway St, Missoula, MT 59802-4008
Phone: (406) 543-7271

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence MED-PAC-LIC-35980 (MT)

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Registry record

NPI: 1063810414
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Dec 2014
Record last updated: 11 Aug 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.