Provider Demographics
NPI:1407477250
Name:LOZOSKIE, JONATHAN (MSOTR/L)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:LOZOSKIE
Suffix:
Gender:M
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 ANNE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-3602
Mailing Address - Country:US
Mailing Address - Phone:410-459-3229
Mailing Address - Fax:
Practice Address - Street 1:10 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4903
Practice Address - Country:US
Practice Address - Phone:410-459-3229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty