Organization
MOSAIC ORTHOTICS AND PROSTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN MOORE CPO (CERTIFIED PROSTHETIST ORTHOTIST)
(719) 231-7893
Entity
Organization
Contact information
Practice address
617 N 17TH ST # 102, COLORADO SPRINGS, CO 80904-3577
(719) 271-5857
Mailing address
6305 MONTARBOR DR, COLORADO SPRINGS, CO 80918-4875
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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