Provider Demographics
NPI:1467996637
Name:KOWALSKI, JESSICA L (DC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 DELTA AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-1127
Mailing Address - Country:US
Mailing Address - Phone:513-321-8484
Mailing Address - Fax:
Practice Address - Street 1:455 DELTA AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45226-1127
Practice Address - Country:US
Practice Address - Phone:513-321-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-07
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4671111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor