Poudre Valley Medical Group, LLC

NPI #1295354801 in Trinidad, Colorado

Provider Information

NPI Number: 1295354801
Entity Type: Organization
Organization Name: Poudre Valley Medical Group, LLC
Primary Specialty: Surgery
Enumeration Date: Apr 14, 2020
Last Updated: Apr 14, 2020

Practice Location

Address: 410 BENEDICTA AVE
City: Trinidad
State: Colorado
ZIP Code: 81082-2005
Phone: (970) 624-4443

Authorized Official

Name: JANA CONROY
Title: CREDENTIALING MANAGER
Phone: (970) 624-4443

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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