Organization
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Active
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.
Other names
Wheat Ridge Clinic - Neurology
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN FRONT RANGE, INC.
Authorized official
JON MCDANIEL (VP FINANCE)
(303) 272-0231
Entity
Organization
Contact information
Practice address
3455 LUTHERAN PKWY STE 285, WHEAT RIDGE, CO 80033-6034
(303) 403-6720
(720) 616-6983
Mailing address
500 ELDORADO BLVD STE 4300, BROOMFIELD, CO 80021-3564
(303) 272-0566
(303) 272-0390
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
10/27/2022
Last updated
06/28/2024
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