Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Primary Care - Fontanero, 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) 365-7420
Entity
Organization
Contact information
Practice address
320 E FONTANERO ST STE 100, COLORADO SPRINGS, CO 80907-7535
(719) 365-7420
(719) 365-7421
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/26/2020
Last updated
08/01/2024
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