| Poudre Valley Medical Group, Llc | |
|
2500 Rocky Mountain Ave Ste 340 Loveland CO 80538-9004 | |
| (970) 495-7421 | |
| (970) 203-7179 |
| Full Name | Poudre Valley Medical Group, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2500 Rocky Mountain Ave Ste 340, Loveland, 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) 495-7421 | Poudre Valley Medical Group, Llc 2500 Rocky Mountain Ave Ste 340 Loveland CO 80538-9004 Ph: (970) 495-7421 |
| NPI Number | 1023647278 |
|---|---|
| Provider Enumeration Date | 04/08/2020 |
| Last Update Date | 04/08/2020 |
| Certification Date | 04/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023647278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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