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General NPI Number Information
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NPI Number | 1386104867
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Entity Type | Organization
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Legal Business Name | KOZASKY CHIROPRACTIC INC.
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 03/21/2019
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Provider Practice Location Address
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Address Line | 15901 HAWTHORNE BLVD STE 460
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City | LAWNDALE
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State | CA
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Zip | 90260-2657
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Country | US
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Telephone | 424-247-7227
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Fax | 323-203-0190
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Provider Business Mailing Address
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Address Line | 8654 STATE ST
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City | SOUTH GATE
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State | CA
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Zip | 90280-2919
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Country | US
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Telephone | 323-788-3993
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KRISTEN KOZASKY
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Credential | DC
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Telephone | 323-716-2761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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