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Organization
CENTENNIAL MEDICAL CLINIC
Active
Organization
CENTENNIAL MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY RILEY (OFFICE MANAGER)
(970) 667-3565
Entity
Organization
Contact information
Practice address
232 W 4TH ST, LOVELAND, CO 80537-5525
(970) 667-3565
(970) 667-2343
Mailing address
232 W 4TH ST, LOVELAND, CO 80537-5525
(970) 667-3565
(970) 667-2343
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15838
CO
207R00000X
Internal Medicine Physician
22781
CO
Other
Enumeration date
01/22/2007
Last updated
09/26/2007
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