Provider Demographics
NPI:1760405385
Name:KOVACH, DAISY MARIE (MS, ATC)
Entity Type:Individual
Prefix:MS
First Name:DAISY
Middle Name:MARIE
Last Name:KOVACH
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1141 BRIDFORD LAKE CIR APT P
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-5172
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 SPRING GARDEN ST
Practice Address - Street 2:136 HHP BUILDING, UNCG ATHLETICS
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-2410
Practice Address - Country:US
Practice Address - Phone:336-334-5925
Practice Address - Fax:336-256-0407
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer