Provider Demographics
NPI:1861605297
Name:COZIER-DOUGLAS, CAROL-ANN ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:CAROL-ANN
Middle Name:ELIZABETH
Last Name:COZIER-DOUGLAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:421 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-2632
Mailing Address - Country:US
Mailing Address - Phone:770-389-1901
Mailing Address - Fax:770-389-3016
Practice Address - Street 1:421 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-2632
Practice Address - Country:US
Practice Address - Phone:770-389-1901
Practice Address - Fax:770-389-3016
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA0006312111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation