# INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INTERMOUNTAIN FRONT RANGE, INC.
- **Other names:** Wellington Maternal Fetal Medicine Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1700545696
- **Legal business name:** INTERMOUNTAIN FRONT RANGE, INC.
- **Authorized official:** JON MCDANIEL (VP FINANCE MEDICAL GROUP)
- **Authorized official phone:** (303) 272-0231

## Contact information

- **Practice address:** 710 WELLINGTON AVE, GRAND JUNCTION, CO 81501-6123
- **Practice address phone:** (970) 298-2275
- **Practice address fax:** (970) 298-7814
- **Mailing address:** 500 ELDORADO BLVD STE 6300, BROOMFIELD, CO 80021-3422
- **Mailing address phone:** (303) 272-0566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2021
- **Last updated:** 06/28/2024