Healthcare Provider Details
I. General information
NPI: 1861492621
Provider Name (Legal Business Name): COLORADO ORTHOTIC & PROSTHETIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2005
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
128 W 5TH AVE
DENVER CO
80204-5105
US
IV. Provider business mailing address
126 W 5TH AVE
DENVER CO
80204-5105
US
V. Phone/Fax
- Phone: 720-685-6520
- Fax: 720-685-6521
- Phone: 208-581-1117
- Fax: 720-858-7052
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | CO |
VIII. Authorized Official
Name: MR.
TIMOTHY
L
O'NEILL
Title or Position: PRESIDENT
Credential:
Phone: 503-407-5408