| Steadfast Spine And Sports Medicine | |
|
1190 Jefferson St Ste 203 Washington MO 63090-4443 | |
| (636) 283-0328 | |
| Not Available |
| Full Name | Steadfast Spine And Sports Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 1190 Jefferson St Ste 203, Washington, Missouri |
| Authorized Official Name and Position | Justin Cosgrove (OWNER) |
| Authorized Official Contact | 6363594663 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Steadfast Spine And Sports Medicine 1190 Jefferson St Ste 203 Washington MO 63090-4443 Ph: (636) 283-0328 | Steadfast Spine And Sports Medicine 1190 Jefferson St Ste 203 Washington MO 63090-4443 Ph: (636) 283-0328 |
| NPI Number | 1952181216 |
|---|---|
| Provider Enumeration Date | 10/04/2023 |
| Last Update Date | 10/04/2023 |
| Medicare PECOS PAC ID | 8628424561 |
|---|---|
| Medicare Enrollment ID | O20231027002587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952181216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Justin Anthony Cosgrove |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1245010743 PECOS PAC ID: 9537515473 Enrollment ID: I20231027002662 |
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