Provider Demographics
NPI:1922150184
Name:DOLEGA-KOWALEWSKI, ISABELLA ANN (PT)
Entity Type:Individual
Prefix:MS
First Name:ISABELLA
Middle Name:ANN
Last Name:DOLEGA-KOWALEWSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 MT. ROYALL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MT. PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464
Mailing Address - Country:US
Mailing Address - Phone:843-810-7227
Mailing Address - Fax:
Practice Address - Street 1:1476 LONG GROVE DRIVE
Practice Address - Street 2:
Practice Address - City:MT. PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464
Practice Address - Country:US
Practice Address - Phone:843-216-3534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3341225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist