Provider Demographics
NPI:1831167774
Name:KOWALSKI, KRISTINA MILIK (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:MILIK
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:ANGELA
Other - Last Name:MILIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 WANDERING MDWS
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-1364
Mailing Address - Country:US
Mailing Address - Phone:413-219-3109
Mailing Address - Fax:
Practice Address - Street 1:2 ALLEN ST
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:MA
Practice Address - Zip Code:01036-9552
Practice Address - Country:US
Practice Address - Phone:413-219-3109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3061111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAV08706Medicare UPIN
MAY45838Medicare ID - Type Unspecified