Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Other names
UCHealth General and Vascular Surgery Clinic - Trinidad
Organization subpart
No
Provider details
NPI number
Authorized official
JANA CONROY (CREDENTIALING MANAGER)
(970) 624-4443
Entity
Organization
Contact information
Practice address
410 BENEDICTA AVE, TRINIDAD, CO 81082-2005
(970) 624-4443
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 624-4443
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
04/14/2020
Last updated
04/14/2020
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