Organization
FORT COLLINS YOUTH CLINIC
Active
Organization
FORT COLLINS YOUTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE FRED (EXECUTIVE ASSISTANT)
(970) 267-9510
Entity
Organization
Contact information
Practice address
1214 OAK PARK DR, FORT COLLINS, CO 80525-7302
(970) 267-9510
(970) 207-9967
Mailing address
PO BOX 7328, LOVELAND, CO 80537-0328
(970) 663-2742
(970) 342-2093
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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