Individual
KEEGAN SHEA COSSIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
3220 N RESERVE ST, MISSOULA, MT 59808-1556
(406) 396-7532
Mailing address
9000 E NICHOLS AVE STE 104, CENTENNIAL, CO 80112-3429
(406) 396-7532
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATR-LAT-LIC-1881
MT
2255A2300X
Athletic Trainer
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Other
Enumeration date
10/05/2017
Last updated
06/02/2020
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