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NPI Code Detail

MEDICARE: COURTNEY KOZAR OTR/L

MEDICARE: COURTNEY KOZAR OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant3778SC
2225X00000XOccupational Therapist6415SC

General Provider Information

NPI Number : 1538716162
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY KOZAR OTR/L
Provider Business Mailing Address
First Line : PO BOX 1312
Second Line :
City : FOUNTAIN INN
State : SC
Zip : 29644-1054
Country : US
Telephone Number : 864-408-9509
Fax Number : 864-335-9036
Provider Business Practice Location Address
First Line : 204 SHADY PINES CT
Second Line :
City : FOUNTAIN INN
State : SC
Zip : 29644-9785
Country : US
Telephone Number : 864-408-9509
Fax Number : 864-335-9036
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2019
Last Update Date : 08/02/2022

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Directions to “ COURTNEY KOZAR OTR/L” Practice Location

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