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Organization

FRONT RANGE CLINIC INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CLARK MCCOY MD (PRESIDENT)
(352) 214-7180
Entity
Organization

Contact information

Practice address
1040 E ELIZABETH ST, SUITE C, FORT COLLINS, CO 80524-3951
(970) 493-9193
Mailing address
1040 E ELIZABETH ST, SUITE C, FORT COLLINS, CO 80524-3951
(970) 493-9193

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0054001
CO
207QA0401X
Addiction Medicine (Family Medicine) Physician
0054001
CO
207QB0002X
Obesity Medicine (Family Medicine) Physician
0054001
CO

Other

Enumeration date
10/04/2015
Last updated
01/12/2021
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