Individual
MARCIA LUCILLE KOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12955 68TH ST SE, ALTO, MI 49302
(616) 868-0001
(616) 868-0030
Mailing address
12955 68TH ST SE, ALTO, MI 49302
(616) 868-0001
(616) 868-0030
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AM410416004
MI
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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