Organization
PROSTHETIC & ORTHOTIC GROUP BOULDER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN MATSUSHIMA CPO (CEO)
(562) 595-6445
Entity
Organization
Contact information
Practice address
2850 IRIS AVE STE I4, BOULDER, CO 80301-1493
(303) 381-4500
(970) 416-9359
Mailing address
2850 IRIS AVE STE I4, BOULDER, CO 80301-1493
(303) 381-4500
(970) 416-9359
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/30/2024
Last updated
09/12/2025
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