| |
2030 Mountain View Ave Ste 300 Longmont CO 80501-3181 | |
(720) 652-8860 | |
(720) 652-8861 |
Full Name | |
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Speciality | Family Medicine |
Location | 2030 Mountain View Ave Ste 300, Longmont, Colorado |
Authorized Official Name and Position | Angela Jo Skinner (ADMINISTRATOR OMA) |
Authorized Official Contact | 7206677283 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 800022 Kansas City MO 64180-0022 Ph: (800) 953-0104 | 2030 Mountain View Ave Ste 300 Longmont CO 80501-3181 Ph: (720) 652-8860 |
NPI Number | 1881320356 |
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Provider Enumeration Date | 07/27/2022 |
Last Update Date | 08/27/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881320356 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
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