Provider Demographics
NPI:1811221518
Name:KOWALESKI, ALLYSON MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLYSON
Middle Name:MARIE
Last Name:KOWALESKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ALLYSON
Other - Middle Name:MARIE
Other - Last Name:SEILER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1014 S FRONT ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-2559
Mailing Address - Country:US
Mailing Address - Phone:614-861-7771
Mailing Address - Fax:614-219-7350
Practice Address - Street 1:1725 BRICE RD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2705
Practice Address - Country:US
Practice Address - Phone:614-861-7771
Practice Address - Fax:614-219-7350
Is Sole Proprietor?:No
Enumeration Date:2009-09-28
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5978152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist