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Organization
AHAVA-5772, LLC
Active
Organization
AHAVA-5772, LLC
Active
Other names
Namaste Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETH JOY KOZAK D.C. (MANAGER)
(561) 596-2714
Entity
Organization
Contact information
Practice address
5540 PGA BOULEVARD, SUITE 100, PALM BEACH GARDENS, FL 33418
(561) 596-2714
Mailing address
5540 PGA BOULEVARD, SUITE 100, PALM BEACH GARDENS, FL 33418
(561) 596-2714
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH7712
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ES056Z
MEDICARE PTAN
FL
Enumeration date
08/31/2016
Last updated
09/02/2016
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