Organization
CERTIFIED PROSTHETICS ORTHOTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CASEY J BRADSHAW (MANAGER)
(970) 356-2123
Entity
Organization
Contact information
Practice address
1620 25TH AVE, SUITE A, GREELEY, CO 80634-4956
(970) 356-2123
(970) 352-4943
Mailing address
1620 25TH AVE, STE A., GREELEY, CO 80634-4956
(970) 356-2123
(970) 352-4943
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76431738
—
CO
Enumeration date
06/19/2007
Last updated
10/27/2009
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