Provider Demographics
NPI:1689997579
Name:KOWALSKI, DAWN MARIE (RPH, PHARM D)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:RPH, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MENOMINEE
Mailing Address - State:MI
Mailing Address - Zip Code:49858-3130
Mailing Address - Country:US
Mailing Address - Phone:906-863-4471
Mailing Address - Fax:906-863-2108
Practice Address - Street 1:1101 7TH AVE
Practice Address - Street 2:
Practice Address - City:MENOMINEE
Practice Address - State:MI
Practice Address - Zip Code:49858-3130
Practice Address - Country:US
Practice Address - Phone:906-863-4471
Practice Address - Fax:906-863-2108
Is Sole Proprietor?:No
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031915183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist