Poudre Valley Medical Group, LLC

NPI #1154937282 in Longmont, Colorado

Provider Information

NPI Number: 1154937282
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: General Practice
Enumeration Date: Sep 23, 2020
Last Updated: Jun 11, 2024

Practice Location

Address: 2900 PEAK AVE
City: Longmont
State: Colorado
ZIP Code: 80504-6236
Phone: (720) 652-4468

Authorized Official

Name: JANA CONROY
Title: DIRECTOR OF CREDENTIALING
Phone: (720) 652-4468

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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