Provider Demographics
NPI:1205029030
Name:MICHAEL R KOWALSKI DC PLLC
Entity Type:Organization
Organization Name:MICHAEL R KOWALSKI DC PLLC
Other - Org Name:KNOBVIEW FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOWALSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-964-9800
Mailing Address - Street 1:8006 SHEPHERDSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-4050
Mailing Address - Country:US
Mailing Address - Phone:502-964-9800
Mailing Address - Fax:502-964-1847
Practice Address - Street 1:8006 SHEPHERDSVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-4050
Practice Address - Country:US
Practice Address - Phone:502-964-9800
Practice Address - Fax:502-964-1847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4524111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY613993OtherACN GROUP
KY7189402OtherAETNA
KY000000275184OtherANTHEM BCBS
KY50000867 GROUP IDOtherPASSPORT HEALTHPLAN
KY3463110OtherCIGNA
KY85002483Medicaid
KY50000868 PERSONALOtherPASSPORT HEALTHPLAN
KY613993OtherUNITED HEALTHCARE
KY7189402OtherAETNA
KY7418 GROUPMedicare PIN
KYU70070Medicare UPIN