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
2004 W 15TH ST STE 3, LOVELAND, CO 80538-3551
(970) 617-8128
Mailing address
1120 E ELIZABETH ST STE G2, FORT COLLINS, CO 80524-4044
(970) 493-9193
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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