Organization
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Active
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.
Other names
SCL Health Medical Group - Lafayette Brain and Spine Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN FRONT RANGE, INC.
Authorized official
JON MCDANIEL (VP FINANCE)
(303) 272-0231
Entity
Organization
Contact information
Practice address
380 EMPIRE RD STE 120, LAFAYETTE, CO 80026-2677
(303) 673-1390
(720) 863-7446
Mailing address
500 ELDORADO BLVD STE 4300, BROOMFIELD, CO 80021-3564
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
03/28/2022
Last updated
07/12/2024
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