Individual
KYRIA KOZACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 N MAIN ST STE B6, ADRIAN, MI 49221-1721
(517) 264-1699
Mailing address
1362 HUTCHINSON RD, CLAYTON, MI 49235-9647
(517) 260-1104
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501004860
MI
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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