Provider Demographics
NPI:1679123657
Name:KAZEE, JOSH
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:KAZEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 BUCKINGHAM SQ
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-8568
Mailing Address - Country:US
Mailing Address - Phone:606-207-4512
Mailing Address - Fax:
Practice Address - Street 1:2204 BUCKINGHAM SQ
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-8568
Practice Address - Country:US
Practice Address - Phone:606-207-4512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY252369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor