# INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INTERMOUNTAIN FRONT RANGE, INC.
- **Other names:** Craig Neurosurgery Outreach Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1245843481
- **Legal business name:** INTERMOUNTAIN FRONT RANGE, INC.
- **Authorized official:** JON MCDANIEL (VP FINANCE MEDICAL GROUP)
- **Authorized official phone:** (303) 272-0231

## Contact information

- **Practice address:** 785 RUSSELL ST, CRAIG, CO 81625-2019
- **Practice address phone:** (970) 298-3188
- **Practice address fax:** (970) 298-3190
- **Mailing address:** 785 RUSSELL ST, CRAIG, CO 81625-2019
- **Mailing address phone:** (970) 826-8019
- **Mailing address fax:** (435) 719-5501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/27/2020
- **Last updated:** 09/17/2024