| Doctor Name: | DANE MICHAEL KOZLEVCAR |
| NPI Number: | 1508151028 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.S.P.T. |
| License Number: | PT020873 |
| Business Practice Address: | 72 Glenmaura National Blvd Suite 102 Moosic, PA - 185072134 |
| Business Phone Number: | 5703444405 |
| Business Fax Number: | 5703444468 |
| Mailing Address: | 1101 E 3rd St, WILLIAMSPORT |
| State: | PA |
| Postal Code: | 177015411 |
| Phone Number: | 5703225500 |
| Fax Number: | 5703228100 |
| NPI Enumeration Date: | 06/13/2011 |
| NPI Last Update Date: | 06/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT020873 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |