Organization
JG LLC
Active
Other names
Family Walk In Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY R GROVER PA-C (OWNER)
(970) 584-2100
Entity
Organization
Contact information
Practice address
2928 W 10TH ST, GREELEY, CO 80634
(970) 584-2100
(970) 584-2101
Mailing address
2928 W 10TH ST, GREELEY, CO 80634-5426
(970) 584-2100
(970) 584-2101
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881101640
—
CO
Enumeration date
01/02/2018
Last updated
03/14/2019
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