Organization
POUDRE VALLEY RADIATION ONCOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLENDA ORR (BUSINESS ADMINISTRATOR)
(303) 427-0648
Entity
Organization
Contact information
Practice address
2121 EAST HARMONY ROAD, SUITE 160, FORT COLLINS, CO 80528-0403
(970) 482-3328
(970) 482-1433
Mailing address
PO BOX 211367, DENVER, CO 80221-0392
(303) 427-0648
(303) 427-0433
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95670033
—
CO
Enumeration date
03/10/2006
Last updated
10/16/2007
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