Provider Demographics
NPI:1083660690
Name:REBOUND RESTORATIVE PROSTHETICS, INC
Entity Type:Organization
Organization Name:REBOUND RESTORATIVE PROSTHETICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:303-832-7287
Mailing Address - Street 1:12213 PECOS ST STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-3414
Mailing Address - Country:US
Mailing Address - Phone:303-457-0272
Mailing Address - Fax:303-457-0618
Practice Address - Street 1:1664 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1579
Practice Address - Country:US
Practice Address - Phone:303-832-7287
Practice Address - Fax:303-830-0327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO71103724Medicaid
CO71103724Medicaid