| Longmont Clinic PC | |
|
1925 W Mountain View Ave Longmont CO 80501-3128 | |
| (720) 494-3173 | |
| (720) 494-3107 |
| Full Name | Longmont Clinic PC |
|---|---|
| Speciality | General Practice |
| Location | 1925 W Mountain View Ave, Longmont, Colorado |
| Authorized Official Name and Position | John P. Stathis (PRESIDENT, BOARD OF DIRECTORS) |
| Authorized Official Contact | 7204943173 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Longmont Clinic PC 1925 W Mountain View Ave Longmont CO 80501-3128 Ph: (720) 494-3173 | Longmont Clinic PC 1925 W Mountain View Ave Longmont CO 80501-3128 Ph: (720) 494-3173 |
| NPI Number | 1043269772 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 12/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043269772 | NPI | - | NPPES |
| 44008 | Other | CO | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (NU) | Primary |
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