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Organization

INTERMOUNTAIN MEDICAL GROUP DENVER, LLC

Active
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.
Other names
Intermountain Health Lutheran Hospital - Wound Care & Hyperbaric Therapy
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
12905 W 40TH AVE, SUILTE 505, WHEAT RIDGE, CO 80401-2794
(303) 265-5470
(303) 325-8516
Mailing address
500 ELDORADO BLVD STE 4300, BROOMFIELD, CO 80021-3564
(303) 272-0566

Taxonomy

Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician

Other

Enumeration date
04/30/2025
Last updated
04/30/2025
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