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Organization
MIDVALLEY FAMILY PRACTICE PC
Active
Organization
MIDVALLEY FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER BORONSKI (OFFICE MANAGER)
(970) 927-4666
Entity
Organization
Contact information
Practice address
1450 E VALLEY RD, SUITE 102, BASALT, CO 81621
(970) 927-4666
(970) 927-6623
Mailing address
1450 E VALLEY RD, SUITE 102, BASALT, CO 81621
(970) 927-4666
(970) 927-6623
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
—
NULL
124Q00000X
Dental Hygienist
—
—
207Q00000X
Family Medicine Physician
Primary
30756
CO
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/06/2006
Last updated
07/07/2020
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