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Organization

POUDRE VALLEY MEDICAL GROUP, LLC

Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Urology Clinic - Printers Park, 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) 365-3700
Entity
Organization

Contact information

Practice address
175 S UNION BLVD STE 315, COLORADO SPRINGS, CO 80910-3126
(719) 365-3700
(719) 365-3701
Mailing address
2695 ROCKY MOUNTAIN AVE, SUITE 150, COLORADO SPRINGS, CO 80910-3126
(719) 365-3700
(719) 365-3701

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Enumeration date
07/30/2020
Last updated
08/05/2024
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