Organization
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Active
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.
Other names
Wheat Ridge Clinic - Diabetes & Endocrinology
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN FRONT RANGE, INC.
Authorized official
JON MCDANIEL (VP FIANANCE)
(303) 272-0231
Entity
Organization
Contact information
Practice address
3555 LUTHERAN PKWY STE 180, WHEAT RIDGE, CO 80033-6000
(303) 403-7933
(303) 403-7945
Mailing address
500 ELDORADO BLVD STE 6300, BROOMFIELD, CO 80021-3422
(303) 272-0566
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Enumeration date
08/21/2020
Last updated
06/28/2024
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