Provider Demographics
NPI:1194380477
Name:KOWAL, BRIAN JOSEPH (DPT, PT)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:KOWAL
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 N RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1053
Mailing Address - Country:US
Mailing Address - Phone:316-448-8339
Mailing Address - Fax:316-221-7149
Practice Address - Street 1:2230 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1053
Practice Address - Country:US
Practice Address - Phone:316-448-8339
Practice Address - Fax:316-221-7149
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist