Provider Demographics
NPI:1477677110
Name:KOZAK, CRAIG GEORGE (DC, PA-C, MSPAS)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:GEORGE
Last Name:KOZAK
Suffix:
Gender:M
Credentials:DC, PA-C, MSPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 N PEARL ST APT 2
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2539
Mailing Address - Country:US
Mailing Address - Phone:720-841-1239
Mailing Address - Fax:
Practice Address - Street 1:660 BANNOCK ST FL 6
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4506
Practice Address - Country:US
Practice Address - Phone:303-602-1590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4879111N00000X
CO363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No111N00000XChiropractic ProvidersChiropractor