NPI 1104342443

Front Range Clinic INC.

Organisation Addiction Medicine (Family Medicine) Physician Longmont, CO

Practice location

Address: 1308 Vivian St, Longmont, CO 80501-3217
Phone: (303) 834-8809
Mailing address: 1040 E Elizabeth St STE C, Fort Collins, CO 80524-3952

Authorised official

Name: Clark McCoy
Title: President
Phone: (352) 214-7180

Registered specialties (2)

Addiction Medicine (Family Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207QA0401X Licence 0054001 (CO)

Other Family Medicine providers in Colorado →

Family Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 0054001 (CO)

Registry record

NPI: 1104342443
Entity type: Organization
NPI issued: 18 Aug 2017
Record last updated: 17 Dec 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.