MEDICARE: ORTHOTIC PROSTHETIC SOLUTIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043208812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOTIC PROSTHETIC SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	1015 ROBERTSON ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3926
Country	:	US
Telephone Number	:	970-484-8388
Fax Number	:	970-419-8870

Provider Business Practice Location Address
First Line	:	1015 ROBERTSON ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3926
Country	:	US
Telephone Number	:	970-484-8388
Fax Number	:	970-419-8870

Authorized Official
Title or Position	:	OWNER
Name	:	BRENDAN JASON RILEY
Credential	:
Telephone Number	:	970-484-8388

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	06/25/2024

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