Provider Demographics
NPI:1467706895
Name:KOWALSKI, KAIZHEN LI
Entity Type:Individual
Prefix:
First Name:KAIZHEN
Middle Name:LI
Last Name:KOWALSKI
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 1:6903 MEADOWCREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:FORTINE
Mailing Address - State:MT
Mailing Address - Zip Code:59918
Mailing Address - Country:US
Mailing Address - Phone:406-882-4490
Mailing Address - Fax:406-882-4495
Practice Address - Street 1:18 PORCUPINE RIDGE
Practice Address - Street 2:
Practice Address - City:FORTINE
Practice Address - State:MT
Practice Address - Zip Code:59918
Practice Address - Country:US
Practice Address - Phone:406-882-4490
Practice Address - Fax:406-882-4495
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1427225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist