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Organization
LIFE ORTHOTICS
Active
Organization
LIFE ORTHOTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMMIE J JAGGARS CDME (OWNER)
(303) 928-1520
Entity
Organization
Contact information
Practice address
9220 KIMMER DR STE 270A, LONE TREE, CO 80124-2878
(303) 928-1520
(720) 294-0170
Mailing address
9220 KIMMER DR STE 270A, LONE TREE, CO 80124-2878
(303) 928-1520
(720) 294-0170
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
NULL
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
NULL
Other
Enumeration date
09/05/2007
Last updated
12/18/2020
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