Organization
PROSTHETIC & ORTHOTIC GROUP OF NORTHERN CO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONIA MARLOW (OPERATIONS DIRECTOR)
(562) 595-6445
Entity
Organization
Contact information
Practice address
2996 GINNALA DR STE 102, LOVELAND, CO 80538-3002
(970) 685-4002
(970) 685-4005
Mailing address
2996 GINNALA DR STE 102, LOVELAND, CO 80538-3002
(970) 685-4002
(970) 685-4005
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1234567890
MEDICARE & MCAID IN PROCESS
CO
Enumeration date
02/25/2010
Last updated
02/25/2010
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