| Poudre Valley Medical Group, Llc | |
|
1400 E Boulder St Ste 1722 Colorado Springs CO 80909-5533 | |
| (719) 364-3640 | |
| Not Available |
| Full Name | Poudre Valley Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 1400 E Boulder St Ste 1722, Colorado Springs, Colorado |
| Authorized Official Name and Position | Jana Conroy (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 7193643640 |
| 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: () - | Poudre Valley Medical Group, Llc 1400 E Boulder St Ste 1722 Colorado Springs CO 80909-5533 Ph: (719) 364-3640 |
| NPI Number | 1902624810 |
|---|---|
| Provider Enumeration Date | 09/30/2024 |
| Last Update Date | 09/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902624810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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