Provider Demographics
NPI:1043507429
Name:KOWALSKI, JOHN THOMAS (MPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:THOMAS
Last Name:KOWALSKI
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 DUKE DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:NE
Mailing Address - Zip Code:68467-2100
Mailing Address - Country:US
Mailing Address - Phone:402-362-6999
Mailing Address - Fax:
Practice Address - Street 1:1521 DUKE DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467-2100
Practice Address - Country:US
Practice Address - Phone:402-362-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1880225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist