| Cosmos Therapy Solutions, Llc | |
|
715 Kensington Ave Ste 14 Missoula MT 59801-5700 | |
| (406) 207-7929 | |
| Not Available |
| Full Name | Cosmos Therapy Solutions, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 715 Kensington Ave Ste 14, Missoula, Montana |
| Authorized Official Name and Position | Kaley Ruth Radermacher (OWNER) |
| Authorized Official Contact | 4062077929 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cosmos Therapy Solutions, Llc 715 Kensington Ave Ste 14 Missoula MT 59801-5700 Ph: (406) 207-7929 | Cosmos Therapy Solutions, Llc 715 Kensington Ave Ste 14 Missoula MT 59801-5700 Ph: (406) 207-7929 |
| NPI Number | 1790327302 |
|---|---|
| Provider Enumeration Date | 10/15/2019 |
| Last Update Date | 10/15/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790327302 | NPI | - | NPPES |
| 1194273730 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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