Individual
SHAYLA KOZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 14TH AVE SE, ALBANY, OR 97322-8502
(541) 223-0179
Mailing address
1801 14TH AVE SE, ALBANY, OR 97322-8502
(541) 223-0179
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ATI4711
OR
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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