| Mr Gerald Joseph Kozak Iii, MPT | |
|
122 S Main St, Almont, MI 48003-1066 | |
| (800) 974-4378 | |
| (630) 515-1536 |
| Full Name | Mr Gerald Joseph Kozak Iii |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 122 S Main St, Almont, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780720250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | L951582 (Michigan) | Secondary |
| 225100000X | Physical Therapist | 5501012904 (Michigan) | Primary |
| Provider Name | Dpt Holdings Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1689648602 PECOS PAC ID: 4688679293 Enrollment ID: O20160930000485 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Gerald Joseph Kozak Iii, MPT 24014 W Renwick Rd Unit 206, Plainfield, IL 60544-8711 Ph: (800) 974-4378 | Mr Gerald Joseph Kozak Iii, MPT 122 S Main St, Almont, MI 48003-1066 Ph: (800) 974-4378 |
Judith Ann Koskodan, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 122 S Main St, Almont, MI 48003 Phone: 800-974-4378 Fax: 630-515-1536 | |
Olivia Kayann Hoover, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 122 S Main St, Almont, MI 48003 Phone: 800-974-4378 Fax: 630-515-1536 | |
Mrs. Jennifer Marie Carrico, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 122 S Main St, Almont, MI 48003 Phone: 800-974-4378 Fax: 630-515-1536 |