| Longmont Integrative Family Practice Pllc | |
|
2130 Mountain View Ave Suite 203 Longmont CO 80501-3177 | |
| (303) 776-8847 | |
| (303) 776-8897 |
| Full Name | Longmont Integrative Family Practice Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2130 Mountain View Ave, Longmont, Colorado |
| Authorized Official Name and Position | Glenda Weeman (PHYSICIAN OWNER) |
| Authorized Official Contact | 3037768847 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Longmont Integrative Family Practice Pllc 2130 Mountain View Ave Suite 203 Longmont CO 80501-3177 Ph: (303) 776-8847 | Longmont Integrative Family Practice Pllc 2130 Mountain View Ave Suite 203 Longmont CO 80501-3177 Ph: (303) 776-8847 |
| NPI Number | 1700229143 |
|---|---|
| Provider Enumeration Date | 04/16/2013 |
| Last Update Date | 07/16/2013 |
| Medicare PECOS PAC ID | 2163662115 |
|---|---|
| Medicare Enrollment ID | O20130716000080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700229143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 50861 (Colorado) | Primary |
| Provider Name | Glenda C Weeman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164789715 PECOS PAC ID: 7113182890 Enrollment ID: I20130718000545 |
| Provider Name | Kymbre S Governson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649670811 PECOS PAC ID: 5991094971 Enrollment ID: I20170817000299 |
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