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JEREMY TRAVIS KOZEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
400 TRACY WAY STE 100, CHARLESTON, WV 25311-1280
(304) 720-0205
Mailing address
407 MCKINLEY AVE, CHARLESTON, WV 25314-1038
(304) 543-1196

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA000975
WV

Other

Enumeration date
09/28/2022
Last updated
09/28/2022
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