| Poudre Valley Medical Group, Llc | |
|
1400 E Boulder St Ste 1200 Colorado Springs CO 80909-5533 | |
| (719) 365-7905 | |
| Not Available |
| Full Name | Poudre Valley Medical Group, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1400 E Boulder St Ste 1200, 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: (719) 365-7905 | Poudre Valley Medical Group, Llc 1400 E Boulder St Ste 1200 Colorado Springs CO 80909-5533 Ph: (719) 365-7905 |
| NPI Number | 1861063471 |
|---|---|
| Provider Enumeration Date | 07/06/2021 |
| Last Update Date | 07/06/2021 |
| Certification Date | 06/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861063471 | NPI | - | NPPES |
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