| Poudre Valley Medical Group, Llc | |
|
2315 E Harmony Rd Ste 110 Fort Collins CO 80528-8623 | |
| (970) 482-4373 | |
| (970) 484-5682 |
| Full Name | Poudre Valley Medical Group, Llc |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 2315 E Harmony Rd Ste 110, Fort Collins, Colorado |
| Authorized Official Name and Position | Jana Conroy (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 9704824373 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Poudre Valley Medical Group, Llc 2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 Ph: (970) 482-4373 | Poudre Valley Medical Group, Llc 2315 E Harmony Rd Ste 110 Fort Collins CO 80528-8623 Ph: (970) 482-4373 |
| NPI Number | 1205458221 |
|---|---|
| Provider Enumeration Date | 05/13/2020 |
| Last Update Date | 06/19/2024 |
| Certification Date | 06/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205458221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Primary |
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