Provider Demographics
NPI:1346483559
Name:KOVACEVIC, JANEEN MARIE
Entity Type:Individual
Prefix:
First Name:JANEEN
Middle Name:MARIE
Last Name:KOVACEVIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3511
Mailing Address - Country:US
Mailing Address - Phone:815-933-7224
Mailing Address - Fax:815-933-7225
Practice Address - Street 1:110 MOONEY DR
Practice Address - Street 2:SUITE 5
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-2171
Practice Address - Country:US
Practice Address - Phone:815-933-7224
Practice Address - Fax:815-933-7225
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist