Provider Demographics
NPI:1285011734
Name:ORTHOTIC PRISTHETIC SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ORTHOTIC PRISTHETIC SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CYNKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-484-8388
Mailing Address - Street 1:1015 ROBERTSON ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3926
Mailing Address - Country:US
Mailing Address - Phone:970-484-8388
Mailing Address - Fax:970-419-8870
Practice Address - Street 1:7336 S. YOSEMITE ST.
Practice Address - Street 2:UNIT 200
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80012-2340
Practice Address - Country:US
Practice Address - Phone:303-770-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO13631730Medicaid