Provider Demographics
NPI:1407283377
Name:COLORADO ORTHOTIC & PROSTHETIC SERVICES WR
Entity Type:Organization
Organization Name:COLORADO ORTHOTIC & PROSTHETIC SERVICES WR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-932-6914
Mailing Address - Street 1:4700 S WADSWORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-1316
Mailing Address - Country:US
Mailing Address - Phone:303-932-6914
Mailing Address - Fax:303-932-1124
Practice Address - Street 1:3550 LUTHERAN PKWY
Practice Address - Street 2:SUITE 205
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6017
Practice Address - Country:US
Practice Address - Phone:303-456-6051
Practice Address - Fax:303-456-6052
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLORADO ORTHOTIC & PROSTHETIC SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-08
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies