Healthcare Provider Details

I. General information

NPI: 1306176839
Provider Name (Legal Business Name): ORTHOCOLORADO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2010
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11650 WEST 2ND PL
LAKEWOOD CO
80228
US

IV. Provider business mailing address

PO BOX 804941
KANSAS CITY MO
64180-4941
US

V. Phone/Fax

Practice location:
  • Phone: 303-629-2193
  • Fax: 303-629-2318
Mailing address:
  • Phone: 303-629-2193
  • Fax: 303-629-2318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name: KATY COMOGLIO
Title or Position: CFO
Credential:
Phone: 720-321-5016