Healthcare Provider Details

I. General information

NPI: 1578583316
Provider Name (Legal Business Name): GRAND VALLEY INTERNAL MEDICINE, ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 PATTERSON RD SUITE 403
GRAND JUNCTION CO
81506-1953
US

IV. Provider business mailing address

425 PATTERSON RD SUITE 403
GRAND JUNCTION CO
81506-1953
US

V. Phone/Fax

Practice location:
  • Phone: 970-244-7460
  • Fax:
Mailing address:
  • Phone: 970-244-7460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE OLSON
Title or Position: PRACTICE MANAGER
Credential:
Phone: 970-244-7460