Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Primary Care - Ken Pratt Blvd
Organization subpart
Yes
Provider details
NPI number
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
JANA CONROY MBA, RHIA (DIRECTOR OF CREDENTIALING)
(720) 718-8410
Entity
Organization
Contact information
Practice address
601 S MAIN ST, LONGMONT, CO 80501-6427
(720) 718-8410
(720) 718-8999
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/26/2021
Last updated
07/12/2024
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