Provider Demographics
NPI:1235260712
Name:KOWALIK, CHRIS A (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:A
Last Name:KOWALIK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-0429
Mailing Address - Country:US
Mailing Address - Phone:978-692-5006
Mailing Address - Fax:978-692-8016
Practice Address - Street 1:3 LITTLETON RD
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3130
Practice Address - Country:US
Practice Address - Phone:978-692-5006
Practice Address - Fax:978-692-8016
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36046Medicare PIN