Organization
GLENWOOD MEDICAL ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIONEL MONTOYA (CFO)
(970) 945-8503
Entity
Organization
Contact information
Practice address
1830 BLAKE AVE, GLENWOOD SPRINGS, CO 81601
(970) 945-8503
(970) 945-0253
Mailing address
1830 BLAKE AVE, GLENWOOD SPRINGS, CO 81601
(970) 945-8503
(970) 945-0253
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207VG0400X
Gynecology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04500088
—
CO
Enumeration date
02/15/2007
Last updated
12/19/2017
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