| Poudre Valley Medical Group, Llc | |
|
4190 E Woodmen Rd Ste 100 Colorado Springs CO 80920-8075 | |
| (719) 365-1950 | |
| Not Available |
| Full Name | Poudre Valley Medical Group, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 4190 E Woodmen Rd Ste 100, Colorado Springs, 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: (193) 651-9507 | Poudre Valley Medical Group, Llc 4190 E Woodmen Rd Ste 100 Colorado Springs CO 80920-8075 Ph: (719) 365-1950 |
| NPI Number | 1083236947 |
|---|---|
| Provider Enumeration Date | 05/14/2020 |
| Last Update Date | 05/14/2020 |
| Certification Date | 05/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083236947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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