Organization
PEDIATRIC URGENT CARE OF NORTHERN COLORADO
Active
Parent organization
FORT COLLINS YOUTH CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FORT COLLINS YOUTH CLINIC
Authorized official
STEPHANIE FRED (PROVIDER RELATIONS)
(970) 267-9510
Entity
Organization
Contact information
Practice address
4845 WEITZEL ST, TIMNATH, CO 80547-4800
(702) 679-5109
(970) 207-9967
Mailing address
1200 E ELIZABETH ST, FORT COLLINS, CO 80524-4007
(970) 267-9510
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
07/29/2014
Last updated
04/28/2021
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