# CLASSICAL ACUPUNCTURE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TRACY L KOZAK
- **Other names:** Classical Acupuncture Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1235796822
- **Legal business name:** TRACY L KOZAK
- **Authorized official:** TRACY L KOZAK LAC (OWNER)
- **Authorized official phone:** (904) 806-3441

## Contact information

- **Practice address:** 260 PASEO REYES DR, SAINT AUGUSTINE, FL 32095-8462
- **Practice address phone:** (904) 806-3441
- **Practice address fax:** (904) 592-5370
- **Mailing address:** 260 PASEO REYES DR, SAINT AUGUSTINE, FL 32095-8462
- **Mailing address phone:** (904) 806-3441
- **Mailing address fax:** (904) 592-5370

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | — | Yes |

## Other

- **Enumeration date:** 05/20/2019
- **Last updated:** 09/07/2020