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Organization

POUDRE VALLEY MEDICAL GROUP, LLC

Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
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)
(719) 364-4120
Entity
Organization

Contact information

Practice address
3843 RIO VISTA DRIVE, SUITE 2200, COLORADO SPRINGS, CO 80917-3381
(719) 364-4120
(719) 364-4121
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
231H00000X
Audiologist

Other

Enumeration date
06/23/2023
Last updated
07/31/2024
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