Individual
MR. BENJAMIN JOHN KOZLOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
225 MEMORIAL DR, BERLIN, WI 54923-1243
(920) 361-1313
Mailing address
2957 BRIGHTON PL, GREEN BAY, WI 54311-6693
(920) 562-2790
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041407585
IL
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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