Healthcare Provider Details

I. General information

NPI: 1194095307
Provider Name (Legal Business Name): ORTHOTIC PROSTHETIC SOLUTIONS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2012
Last Update Date: 10/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 BROADWAY STE 2E
DENVER CO
80221-2918
US

IV. Provider business mailing address

1015 ROBERTSON ST
FORT COLLINS CO
80524-3926
US

V. Phone/Fax

Practice location:
  • Phone: 303-316-2615
  • Fax: 303-331-9019
Mailing address:
  • Phone: 970-484-8388
  • Fax: 970-419-8870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AARON KRATOHVIL
Title or Position: CONTROLLER
Credential:
Phone: 615-550-8760