| Poudre Valley Medical Group, Llc | |
|
3520 E 15th St Ste 201 Loveland CO 80538-8939 | |
| (970) 669-9100 | |
| (970) 669-0440 |
| Full Name | Poudre Valley Medical Group, Llc |
|---|---|
| Speciality | Pediatrics |
| Location | 3520 E 15th St Ste 201, Loveland, Colorado |
| Authorized Official Name and Position | Jana Conroy (MANAGER CREDENTIALING) |
| 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) 624-4443 | Poudre Valley Medical Group, Llc 3520 E 15th St Ste 201 Loveland CO 80538-8939 Ph: (970) 669-9100 |
| NPI Number | 1649864448 |
|---|---|
| Provider Enumeration Date | 02/23/2021 |
| Last Update Date | 02/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649864448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
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