Organization
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Active
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.
Other names
Lafayette Clinic Neurology
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN FRONT RANGE, INC.
Authorized official
JON MCDANIEL (VP FINANCE)
(303) 272-0231
Entity
Organization
Contact information
Practice address
300 EXEMPLA CIR STE 230, LAFAYETTE, CO 80026-2906
(303) 673-1370
(720) 616-6995
Mailing address
500 ELDORADO BLVD STE 4300, BROOMFIELD, CO 80021-3564
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
03/08/2022
Last updated
06/28/2024
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