| Poudre Valley Medical Group, Llc | |
|
1760 E Ken Pratt Blvd 1.220, 1.222 Longmont CO 80504-5311 | |
| (720) 718-5140 | |
| (720) 516-0246 |
| Full Name | Poudre Valley Medical Group, Llc |
|---|---|
| Speciality | General Practice |
| Location | 1760 E Ken Pratt Blvd, Longmont, Colorado |
| Authorized Official Name and Position | Jana Conroy (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 7207185140 |
| 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 1760 E Ken Pratt Blvd 1.220, 1.222 Longmont CO 80504-5311 Ph: (720) 718-5140 |
| NPI Number | 1225742000 |
|---|---|
| Provider Enumeration Date | 01/06/2023 |
| Last Update Date | 07/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225742000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 208M00000X | Hospitalist | (* (Not Available)) | Secondary |
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