Healthcare Provider Details

I. General information

NPI: 1235260712
Provider Name (Legal Business Name): CHRIS A. KOWALIK DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 LITTLETON RD
WESTFORD MA
01886-3130
US

IV. Provider business mailing address

PO BOX 429
WESTFORD MA
01886-0429
US

V. Phone/Fax

Practice location:
  • Phone: 978-692-5006
  • Fax: 978-692-8016
Mailing address:
  • Phone: 978-692-5006
  • Fax: 978-692-8016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1519
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: