| Poudre Valley Medical Group, Llc | |
|
9540 Park Meadows Dr Lone Tree CO 80124-2894 | |
| (720) 516-9014 | |
| (720) 848-2201 |
| Full Name | Poudre Valley Medical Group, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 9540 Park Meadows Dr, Lone Tree, Colorado |
| Authorized Official Name and Position | Jana Conroy (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9706244443 |
| 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) 624-4443 | Poudre Valley Medical Group, Llc 9540 Park Meadows Dr Lone Tree CO 80124-2894 Ph: (720) 516-9014 |
| NPI Number | 1497323471 |
|---|---|
| Provider Enumeration Date | 06/15/2021 |
| Last Update Date | 06/15/2021 |
| Certification Date | 06/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497323471 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
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