Poudre Valley Medical Group, LLC

NPI #1033939095 in Fountain, Colorado

Provider Information

NPI Number: 1033939095
Entity Type: Organization
Organization Name: Poudre Valley Medical Group, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: POUDRE VALLEY MEDICAL GROUP, LLC
Primary Specialty: Family Medicine
Enumeration Date: Oct 15, 2024
Last Updated: Oct 15, 2024

Practice Location

Address: 6161 TIMBER RAIL POINT
Address 2: SUITE 100
City: Fountain
State: Colorado
ZIP Code: 80817
Phone: (719) 365-0110

Authorized Official

Name: JANA CONROY
Title: DIRECTOR OF CREDENTIALING
Phone: (719) 365-0110

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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