OrganizationActive
Front Range Clinic Inc.
NPI 1063008522 · Addiction Medicine (Family Medicine) Physician · Pueblo, CO
Provider details
- NPI number
- 1063008522
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Clark Mccoy, President(970) 493-9193
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Practice location
1249 E Routt Ave
Pueblo, CO 81004-2908
Phone: (720) 808-0051
Approximate (ZIP-level) locationGet directions
Mailing address
1120 E Elizabeth St Ste G2
Fort Collins, CO 80524-4044
Registry dates
- Enumerated
- 2020-12-17
- Last updated
- 2020-12-17
- Certified
- 2020-12-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.