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Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
JANA CONROY (DIRECTOR CREDENTIALING)
(970) 624-4443
Entity
Organization
Contact information
Practice address
1306 FORTINO BLVD STE 110, PUEBLO, CO 81008-1794
(719) 546-1000
(719) 546-1011
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
NULL
207RP1001X
Pulmonary Disease Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
Other
Enumeration date
08/08/2025
Last updated
08/08/2025
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