Longmont Clinic Pc | |
1925 W Mountain View Ave Longmont CO 80501-3128 | |
(720) 494-3173 | |
(720) 494-3107 |
Full Name | Longmont Clinic Pc |
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Speciality | General Practice |
Location | 1925 W Mountain View Ave, Longmont, Colorado |
Authorized Official Name and Position | John P. Stathis (PRESIDENT, BOARD OF DIRECTORS) |
Authorized Official Contact | 7204943173 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Longmont Clinic Pc 1925 W Mountain View Ave Longmont CO 80501-3128 Ph: (720) 494-3173 | Longmont Clinic Pc 1925 W Mountain View Ave Longmont CO 80501-3128 Ph: (720) 494-3173 |
NPI Number | 1043269772 |
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Provider Enumeration Date | 05/09/2006 |
Last Update Date | 12/12/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043269772 | NPI | - | NPPES |
44008 | Other | CO | MEDICARE GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
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