| Poudre Valley Medical Group, Llc | |
|
256 W Mountain Ave Fort Collins CO 80521-2711 | |
| (970) 962-7105 | |
| Not Available |
| Full Name | Poudre Valley Medical Group, Llc |
|---|---|
| Speciality | General Practice |
| Location | 256 W Mountain Ave, Fort Collins, 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) 962-7105 | Poudre Valley Medical Group, Llc 256 W Mountain Ave Fort Collins CO 80521-2711 Ph: (970) 962-7105 |
| NPI Number | 1932728706 |
|---|---|
| Provider Enumeration Date | 04/13/2020 |
| Last Update Date | 04/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932728706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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