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Organization

POUDRE VALLEY MEDICAL GROUP, LLC

Active
Other names
UCHealth Occupational Medicine Clinic - Lake Street
Organization subpart
No

Provider details

NPI number
Authorized official
JANA CONROY (CREDENTIALING MANAGER)
(970) 624-4443
Entity
Organization

Contact information

Practice address
151 W LAKE ST STE 1500, FORT COLLINS, CO 80524-4124
(970) 237-8250
(970) 237-8294
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 237-8250
(970) 237-8294

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary

Other

Enumeration date
01/27/2020
Last updated
01/27/2020
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