Poudre Valley Medical Group, LLC

NPI #1164023313 in Fort Collins, Colorado

Provider Information

NPI Number: 1164023313
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: Neurological Surgery
Enumeration Date: Nov 4, 2020
Last Updated: Jun 7, 2024

Practice Location

Address: 1107 S LEMAY AVE STE 240
City: Fort Collins
State: Colorado
ZIP Code: 80524-3959
Phone: (970) 495-7421

Authorized Official

Name: JANA CONROY
Title: DIRECTOR OF CREDENTIALING
Phone: (970) 495-7421

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychiatry & Neurology - Neurology — Neurology	2084N0400X
Neurological Surgery	207T00000X	Primary

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