Provider Demographics
NPI:1386104867
Name:KOZASKY CHIROPRACTIC INC.
Entity type:Organization
Organization Name:KOZASKY CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOZASKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-716-2761
Mailing Address - Street 1:8654 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-2919
Mailing Address - Country:US
Mailing Address - Phone:323-788-3993
Mailing Address - Fax:
Practice Address - Street 1:15901 HAWTHORNE BLVD STE 460
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2657
Practice Address - Country:US
Practice Address - Phone:424-247-7227
Practice Address - Fax:323-203-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty