Healthcare Provider Details

I. General information

NPI: 1871665547
Provider Name (Legal Business Name): HORIZON PROSTHETICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 ELKTON DR STE E
COLORADO SPRINGS CO
80907-3555
US

IV. Provider business mailing address

200 S WILCOX ST # 245
CASTLE ROCK CO
80104-1913
US

V. Phone/Fax

Practice location:
  • Phone: 719-266-0949
  • Fax: 719-266-0941
Mailing address:
  • Phone: 719-266-0949
  • Fax: 719-266-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number20156000418
License Number StateCO

VIII. Authorized Official

Name: MRS. TAMMY J MCKENNA
Title or Position: CFO
Credential:
Phone: 303-660-1238