Provider Demographics
NPI:1346488756
Name:KOWALSKI, MICHAEL (AP, DR AC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:KOWALSKI
Suffix:
Gender:M
Credentials:AP, DR AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4237 SALISBURY ROAD N.
Mailing Address - Street 2:SUITE 107
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216
Mailing Address - Country:US
Mailing Address - Phone:904-296-9545
Mailing Address - Fax:904-296-9547
Practice Address - Street 1:4237 SALISBURY ROAD N.
Practice Address - Street 2:SUITE 107
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216
Practice Address - Country:US
Practice Address - Phone:904-296-9545
Practice Address - Fax:904-296-9547
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP208171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist