Provider Demographics
NPI:1902097991
Name:KOWALSKI, MARK E (CHIROPRACTOR DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:E
Last Name:KOWALSKI
Suffix:
Gender:M
Credentials:CHIROPRACTOR DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6151 AVERY RD STE B
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9614
Mailing Address - Country:US
Mailing Address - Phone:614-975-4579
Mailing Address - Fax:614-798-8018
Practice Address - Street 1:6151 AVERY RD STE B
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9614
Practice Address - Country:US
Practice Address - Phone:614-975-4579
Practice Address - Fax:614-798-8018
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1148111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311160498Medicaid