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General NPI Number Information
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NPI Number | 1003742172
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Entity Type | Individual
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Provider Name | MASON KOSIK
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Gender | Male
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Dates
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Enumeration Date | 06/18/2026
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Last Update Date | 06/18/2026
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Provider Practice Location Address
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Address Line | 4221 GARRETT RD STE 1-2
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City | DURHAM
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State | NC
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Zip | 27707-3467
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Country | US
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Telephone | 919-493-1204
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Fax | 984-250-0156
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Provider Business Mailing Address
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Address Line | 10829 ROUGEMONT RD
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City | BAHAMA
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State | NC
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Zip | 27503-8963
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P25005
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License Number State | NC
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