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General NPI Number Information
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NPI Number | 1619871282
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Entity Type | Organization
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Legal Business Name | INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 2570 PATTERSON RD
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City | GRAND JUNCTION
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State | CO
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Zip | 81505-1438
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Country | US
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Telephone | 303-403-3309
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Fax | 303-812-5186
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Provider Business Mailing Address
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Address Line | 500 ELDORADO BLVD STE 4300
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City | BROOMFIELD
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State | CO
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Zip | 80021-3564
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE CHIEF MEDICAL OFFICER
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Name | AWTREY CHRISTOPHER
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Credential | MD
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Telephone | 303-272-0756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | NULL
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