Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH7712 | FL |
N | 111NN1001X | Nutrition | CH7712 | FL |
NPI | 1265733604 |
---|---|
Provider Name | Dr. Beth Joy Kozak |
First Address | Palm Beach Gardens, FL 33410-2171 |
Second Address | Palm Beach Gardens, FL 33410-2171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2010 |
Last Update Date | 02/09/2016 |