Organization
PERFORMANCE ORTHOTICS & PROSTHETICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH BUSH CPO (PRESIDENT)
(719) 425-6007
Entity
Organization
Contact information
Practice address
729 FORTINO BLVD STE A, PUEBLO, CO 81008-2089
(719) 425-6007
Mailing address
729 FORTINO BLVD STE A, PUEBLO, CO 81008-2089
(719) 425-6007
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
CO
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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