Provider Demographics
NPI:1508951013
Name:KOWALSKE, PHILIP F (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:F
Last Name:KOWALSKE
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 1:1820 LOWER ROSWELL ROAD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-3344
Mailing Address - Country:US
Mailing Address - Phone:678-560-2449
Mailing Address - Fax:678-560-2449
Practice Address - Street 1:1820 LOWER ROSWELL ROAD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-3344
Practice Address - Country:US
Practice Address - Phone:678-560-2449
Practice Address - Fax:678-560-2449
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor