Organization
COLORADO ORTHOTIC & PROSTHETIC SERVICES, LLC
Active
Other names
Evergreen Prosthetics and Orthotics, Evergreen Prosthetics & Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY L O'NEILL (PRESIDENT)
(503) 407-5408
Entity
Organization
Contact information
Practice address
128 W 5TH AVE, DENVER, CO 80204-5105
(720) 685-6520
(720) 685-6521
Mailing address
126 W 5TH AVE, DENVER, CO 80204-5105
(208) 581-1117
(720) 858-7052
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
CO
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67632751
—
CO
Enumeration date
07/22/2005
Last updated
06/11/2025
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