Longs Peak Family Practice, PC

NPI #1477565380 in Longmont, Colorado

Provider Information

NPI Number: 1477565380
Entity Type: Organization
Organization Name: Longs Peak Family Practice, PC
Primary Specialty: Family Medicine
Enumeration Date: Aug 12, 2006
Last Updated: Feb 8, 2008

Practice Location

Address: 1309 SUNSET ST
City: Longmont
State: Colorado
ZIP Code: 80501-3215
Phone: (303) 772-5578

Authorized Official

Name: DR. SUSAN I ROACH, M.D.
Title: OFFICER
Phone: (303) 772-5578

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine - Sports Medicine — Sports Medicine	207QS0010X
Family Medicine	207Q00000X	Primary

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