Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
JANA CONROY (DIRECTOR OF CREDENTIALING)
(307) 742-9411
Entity
Organization
Contact information
Practice address
3116 WILLETT DR, LARAMIE, WY 82072-5048
(307) 742-9411
(307) 742-9423
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(307) 742-9411
(307) 742-9423
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
04/22/2020
Last updated
06/19/2024
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