Organization
FRONT RANGE CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK STEVEN MCCOY MD (PRESIDENT)
(970) 493-9193
Entity
Organization
Contact information
Practice address
1304 N ACADEMY BLVD STE 102, COLORADO SPRINGS, CO 80909-3318
(719) 419-7735
Mailing address
1120 E ELIZABETH ST STE G, FORT COLLINS, CO 80524-4044
(970) 493-9193
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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