Healthcare Provider Details

I. General information

NPI: 1841433984
Provider Name (Legal Business Name): SHELIA LEE KOZEL LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 04/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 ELM ST
CLAREMONT NH
03743-4939
US

IV. Provider business mailing address

7 LAUREL ST
CLAREMONT NH
03743-5203
US

V. Phone/Fax

Practice location:
  • Phone: 603-504-6254
  • Fax:
Mailing address:
  • Phone: 603-504-6254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number1755M
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: