Provider Demographics
NPI:1407166010
Name:COZZA, JOSEPH ANTHONY (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:COZZA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 401805
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89140-1805
Mailing Address - Country:US
Mailing Address - Phone:702-396-4993
Mailing Address - Fax:702-636-4990
Practice Address - Street 1:6592 N. DECATUR BLVD.
Practice Address - Street 2:SUITE# 115
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-1038
Practice Address - Country:US
Practice Address - Phone:702-396-4993
Practice Address - Fax:702-636-4990
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01252111N00000X, 111NN1001X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition