| Front Range Clinic Inc. | |
|
4720 Table Mesa Dr Ste B100 Boulder CO 80305-5595 | |
| (720) 476-7957 | |
| Not Available |
| Full Name | Front Range Clinic Inc. |
|---|---|
| Speciality | Family Medicine - Addiction Medicine |
| Location | 4720 Table Mesa Dr Ste B100, Boulder, Colorado |
| Authorized Official Name and Position | Clark Steven Mccoy (PRESIDENT) |
| Authorized Official Contact | 9704939193 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Front Range Clinic Inc. 1120 E Elizabeth St Ste G2 Fort Collins CO 80524-4044 Ph: (970) 493-9193 | Front Range Clinic Inc. 4720 Table Mesa Dr Ste B100 Boulder CO 80305-5595 Ph: (720) 476-7957 |
| NPI Number | 1760078224 |
|---|---|
| Provider Enumeration Date | 12/17/2020 |
| Last Update Date | 12/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760078224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207QA0401X | Family Medicine - Addiction Medicine | (* (Not Available)) | Primary |
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