Organization
MOSAIC ORTHOTICS AND PROSTHETICS LLC
Active
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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