Organization
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Active
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.
Other names
Central Park Clinic - Gynological Oncology
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN FRONT RANGE, INC.
Authorized official
JON MCDANIEL (VP FINANCE)
(303) 272-0231
Entity
Organization
Contact information
Practice address
2823 ROSLYN ST, DENVER, CO 80238-2624
(303) 403-6330
Mailing address
500 ELDORADO BLVD STE 4300, BROOMFIELD, CO 80021-3564
(303) 272-0566
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
—
—
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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