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General NPI Number Information
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NPI Number | 1588062764
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Entity Type | Organization
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Legal Business Name | PROSTHETIC & ORTHOTIC GROUP PEDIATRIC SPECIALISTS - COLORADO LLC
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 13123 E 16TH AVE MAIL BOX B060
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City | AURORA
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State | CO
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Zip | 80045-7106
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Country | US
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Telephone | 303-400-8866
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Fax | 970-416-9359
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Provider Business Mailing Address
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Address Line | 37 SHUMAN AVE
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City | STOUGHTON
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State | MA
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Zip | 02072-3734
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Country | US
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Telephone | 508-638-1172
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Fax | 508-588-7944
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | THOMAS H MORRISSEY
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Credential |
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Telephone | 508-588-6060
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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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