| Poudre Valley Medical Group, Llc | |
|
400 W 16th St Pueblo CO 81003-2745 | |
| (719) 584-4921 | |
| (719) 595-7994 |
| Full Name | Poudre Valley Medical Group, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 400 W 16th St, Pueblo, Colorado |
| Authorized Official Name and Position | Jana Conroy (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 7195844921 |
| 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 400 W 16th St Pueblo CO 81003-2745 Ph: (719) 584-4921 |
| NPI Number | 1225847460 |
|---|---|
| Provider Enumeration Date | 01/02/2025 |
| Last Update Date | 01/02/2025 |
| Certification Date | 01/02/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225847460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 261QE0002X | Clinic/center - Emergency Care | (* (Not Available)) | Secondary |
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