Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Other names
UCHealth Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JANA CONROY (CREDENTIALING MANAGER)
(970) 624-4443
Entity
Organization
Contact information
Practice address
910 RUSH DR, SALIDA, CO 81201-9665
(719) 539-6637
(719) 539-5275
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(719) 539-6637
(719) 539-5275
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
01/28/2020
Last updated
02/02/2021
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