National Provider Identifier Database

FRONT RANGE CLINIC INC
Addiction Medicine


Contact Information

FRONT RANGE CLINIC INC.
1410 VANCE ST STE 211
LAKEWOOD, CO80214-5435
Phone: 720-597-5576
Fax: 970-639-4475
Website:
Specialty Taxonomy Code
* Addiction Medicine 207QA0401X
Bariatric Medicine 207QB0002X
Family Medicine 207Q00000X

* Indicates primary specialty

NPI Profile & details for FRONT RANGE CLINIC INC.

NPI Number 1356860803
Legal business name
LBN
FRONT RANGE CLINIC INC.
Authorized official CLARK MCCOY - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 09/15/2017
Last updated 02/02/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • CO Medicaid: 1598135451

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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