| Ketamine West Llc | |
|
836 S Townsend Ave Ste A Montrose CO 81401-4360 | |
| (970) 200-8365 | |
| Not Available |
| Full Name | Ketamine West Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 836 S Townsend Ave Ste A, Montrose, Colorado |
| Authorized Official Name and Position | Stryder River Reilly (NURSE PRACTITIONER) |
| Authorized Official Contact | 9706441279 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ketamine West Llc 602 26 1/2 Rd Grand Junction CO 81506-1905 Ph: (970) 644-1279 | Ketamine West Llc 836 S Townsend Ave Ste A Montrose CO 81401-4360 Ph: (970) 200-8365 |
| NPI Number | 1003529728 |
|---|---|
| Provider Enumeration Date | 12/27/2022 |
| Last Update Date | 09/06/2023 |
| Certification Date | 12/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003529728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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