Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Heart and Vascular Clinic - Bridgeport, UCHealth Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
JANA CONROY (DIRECTOR OF CREDENTIALING)
(308) 262-1616
Entity
Organization
Contact information
Practice address
1313 S ST, BRIDGEPORT, NE 69336-2563
(308) 262-1616
(308) 262-1529
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(308) 262-1616
(308) 262-1529
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
Other
Enumeration date
02/01/2020
Last updated
07/24/2024
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