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General NPI Number Information
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NPI Number | 1578496832
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Entity Type | Organization
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Legal Business Name | PHOENIX ORTHOTICS AND PROSTHETICS LLC
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Dates
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Enumeration Date | 06/05/2026
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Last Update Date | 06/05/2026
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Provider Practice Location Address
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Address Line | 1601 E 19TH AVE STE 3650
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City | DENVER
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State | CO
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Zip | 80218-1282
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Country | US
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Telephone | 970-694-2971
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Fax | 970-792-8544
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Provider Business Mailing Address
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Address Line | 3950 JOHN F KENNEDY PKWY UNIT 8C
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City | FORT COLLINS
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State | CO
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Zip | 80525-3074
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Country | US
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Telephone | 720-496-8800
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Fax | 970-792-8544
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Authorized Official
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Title or Position | OWNER
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Name | ELICHA ROBERTS
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Credential | CPO
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Telephone | 970-694-2971
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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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