Provider Demographics
NPI:1003620329
Name:CMC MULTISPECIALTY CARE COMO LLC
Entity type:Organization
Organization Name:CMC MULTISPECIALTY CARE COMO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASTON
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSOWRTHY
Authorized Official - Suffix:
Authorized Official - Credentials:DC, FNP-BC
Authorized Official - Phone:816-674-2693
Mailing Address - Street 1:8809 SE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-7858
Mailing Address - Country:US
Mailing Address - Phone:816-674-2693
Mailing Address - Fax:816-674-2693
Practice Address - Street 1:305 N KEENE ST STE 105A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6897
Practice Address - Country:US
Practice Address - Phone:816-674-2693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies