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)
(720) 718-5140
Entity
Organization
Contact information
Practice address
1760 E KEN PRATT BLVD, 1.220, 1.222, LONGMONT, CO 80504-5311
(720) 718-5140
(720) 516-0246
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
01/06/2023
Last updated
07/12/2024
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