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General NPI Number Information
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NPI Number | 1548340136
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Entity Type | Organization
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Legal Business Name | WESTERN SLOPE ORTHOTICS
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 840 ROOD AVE
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-3434
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Country | US
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Telephone | 970-241-7042
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Fax | 970-248-0083
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Provider Business Mailing Address
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Address Line | 840 ROOD AVE
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-3434
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Country | US
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Telephone | 970-241-7042
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Fax | 970-248-0083
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GREG MOORE
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Credential | C .O.
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Telephone | 970-243-9255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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