Organization Name: | POUDRE VALLEY OPEN MRI, LLC |
NPI Number: | 1023065844 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL P BELICK (C.E.O.) |
Mailing Address: | 2420 E Prospect Rd Fort Collins |
State: | CO US |
Postal Code: | 805259729 |
Phone Number: | 9704930567 |
Fax Number: | |
NPI Enumeration Date: | 05/27/2006 |
NPI Last Update Date: | 07/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |