Graduated: 2020
NPI: 1932708013
Practice Locations (2)
POUDRE VALLEY MEDICAL GROUP LLC
6705 RANGEWOOD DR
COLORADO SPRINGS, CO 809187300
7195997331
SOUTHERN COLORADO CLINIC PC
3676 PARKER BLVD, SUITE 290
PUEBLO, CO 810082214
7195532200
Source: CMS National Downloadable File, September 2026.