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Organization
BENDER MEDICAL GROUP
Active
Organization
BENDER MEDICAL GROUP
Active
Other names
Miramont Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE M DESAIRE (CBDO)
(970) 225-5107
Entity
Organization
Contact information
Practice address
313 W DRAKE RD, FORT COLLINS, CO 80526-2846
(970) 482-8881
(970) 482-9646
Mailing address
313 W DRAKE RD, FORT COLLINS, CO 80526-2846
(970) 482-8881
(970) 482-9646
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
32679
CO
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/20/2013
Last updated
02/10/2020
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