OrganizationActive
Front Range Clinic Inc.
NPI 1104342443 · Addiction Medicine (Family Medicine) Physician · Longmont, CO
Provider details
- NPI number
- 1104342443
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Clark Mccoy, President(352) 214-7180
- License
- 0054001 (CO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1308 Vivian St
Longmont, CO 80501-3217
Phone: (303) 834-8809
Approximate (ZIP-level) locationGet directions
Mailing address
1040 E Elizabeth St Ste C
Fort Collins, CO 80524-3952
Registry dates
- Enumerated
- 2017-08-18
- 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.