Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Medical Group, UCHealth Interventional Psychiatry Clinic - Longmont
Organization subpart
Yes
Provider details
NPI number
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
JANA CONROY (DIRECTOR OF CREDENTIALING)
(720) 718-8310
Entity
Organization
Contact information
Practice address
1760 E KEN PRATT BLVD STE 305, LONGMONT, CO 80504-5311
(720) 718-8310
(720) 718-0363
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/22/2020
Last updated
08/01/2024
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