Organization
FRONT RANGE CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARK MCCOY MD (PRESIDENT)
(352) 214-7180
Entity
Organization
Contact information
Practice address
2224 S FRASER ST UNIT 3, AURORA, CO 80014-4532
(720) 484-4428
(970) 639-4475
Mailing address
1040 E ELIZABETH ST STE C, FORT COLLINS, CO 80524-3952
(970) 493-9193
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
207QB0002X
Obesity Medicine (Family Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598135451
—
CO
Enumeration date
09/15/2017
Last updated
12/17/2020
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