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Organization

COLORADO MOUNTAIN MEDICAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANE VOYTKO (PHYSICIAN PRESIDENT)
(970) 926-6340
Entity
Organization

Contact information

Practice address
377 SYLVAN LAKE RD STE 210, EAGLE, CO 81631-6779
(970) 926-6340
(970) 926-6348
Mailing address
PO BOX 4330, AVON, CO 81620-4330
(970) 845-2903
(970) 926-6348

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
207ND0900X
Dermatopathology Physician
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
207V00000X
Obstetrics & Gynecology Physician
208000000X
Pediatrics Physician
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
06/23/2020
Last updated
06/08/2022
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