# INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SISTERS OF CHARITY LEAVENWORTH HEALTH SYSTEM INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1356835045
- **Legal business name:** SISTERS OF CHARITY LEAVENWORTH HEALTH SYSTEM INC
- **Authorized official:** JON MCDANIEL (VP FINANCE MGPS)
- **Authorized official phone:** (303) 272-0231

## Contact information

- **Practice address:** 627 25 1/2 RD, GRAND JUNCTION, CO 81505-6401
- **Practice address phone:** (970) 242-3535
- **Practice address fax:** (970) 683-2745
- **Mailing address:** 500 ELDORADO BLVD STE 6250, BROOMFIELD, CO 80021-3421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 06/18/2018
- **Last updated:** 06/28/2024