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Organization

POUDRE VALLEY MEDICAL GROUP, LLC

Active
Other names
UCHealth Memorial Hospital North
Organization subpart
No

Provider details

NPI number
Authorized official
JANA CONROY (CREDENTIALING MANAGER)
(970) 624-4443
Entity
Organization

Contact information

Practice address
4050 BRIARGATE PKWY FL 4, COLORADO SPRINGS, CO 80920-7815
(719) 365-1292
(719) 365-5004
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(719) 365-1292
(719) 365-5004

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Enumeration date
05/13/2020
Last updated
05/13/2020
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