| Poudre Valley Medical Group, Llc | |
|
1750 E Ken Pratt Blvd Longmont CO 80504-5311 | |
| (720) 718-7000 | |
| (720) 718-0900 |
| Full Name | Poudre Valley Medical Group, Llc |
|---|---|
| Speciality | Hospitalist |
| Location | 1750 E Ken Pratt Blvd, Longmont, Colorado |
| Authorized Official Name and Position | Jana Conroy (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 7207187000 |
| 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: () - | Poudre Valley Medical Group, Llc 1750 E Ken Pratt Blvd Longmont CO 80504-5311 Ph: (720) 718-7000 |
| NPI Number | 1912506767 |
|---|---|
| Provider Enumeration Date | 10/22/2020 |
| Last Update Date | 08/19/2024 |
| Certification Date | 08/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912506767 | NPI | - | NPPES |
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