Individual
ELIZABETH ASHLEY KOZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
15474 N HAGGERTY RD, PLYMOUTH, MI 48170-4893
(734) 335-6103
(630) 734-4715
Mailing address
15474 N HAGGERTY RD, PLYMOUTH, MI 48170-4893
(734) 335-6103
(630) 734-4715
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085.004076
IL
Other
Enumeration date
08/16/2011
Last updated
06/22/2015
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