Provider Demographics
NPI:1770542102
Name:KOWALCHICK, JANET TAYLOR (MPT)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:TAYLOR
Last Name:KOWALCHICK
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:TAYLOR
Other - Last Name:KOWALCHICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4944
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762
Mailing Address - Country:US
Mailing Address - Phone:760-608-1873
Mailing Address - Fax:760-495-0300
Practice Address - Street 1:991 GOVERNOR DRIVE
Practice Address - Street 2:SUITE 104
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762
Practice Address - Country:US
Practice Address - Phone:760-608-1873
Practice Address - Fax:760-446-3893
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA221022251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic