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Individual

MICHAEL ROBERT KOZLOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D., PH.D.

Contact information

Practice address
5865 W UTOPIA RD, GLENDALE, AZ 85308-5251
(623) 806-7200
Mailing address
19389 N 59TH AVE, GLENDALE, AZ 85308-6500
(623) 537-6000
(623) 537-6014

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1815
AZ

Other

Enumeration date
06/20/2011
Last updated
12/11/2019
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