Justin Cosgrove, DC | |
1190 Jefferson St Ste 203, Washington, MO 63090-4443 | |
(636) 359-4663 | |
Not Available |
Full Name | Justin Cosgrove |
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Gender | Male |
Speciality | Chiropractor |
Location | 1190 Jefferson St Ste 203, Washington, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245010743 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 2023039645 (Missouri) | Primary |
Provider Name | Steadfast Spine And Sports Medicine |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1952181216 PECOS PAC ID: 8628424561 Enrollment ID: O20231027002587 |
Mailing Address | Practice Location Address |
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Justin Cosgrove, DC 1190 Jefferson St Ste 203, Washington, MO 63090-4443 Ph: (636) 283-0328 | Justin Cosgrove, DC 1190 Jefferson St Ste 203, Washington, MO 63090-4443 Ph: (636) 359-4663 |
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