Healthcare Provider Details

I. General information

NPI: 1932535358
Provider Name (Legal Business Name): KAREN J KOWALCZYK H.I.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MILLER TRUNK HWY STE 500
DULUTH MN
55811-5644
US

IV. Provider business mailing address

1802 GALLOWAY ST
EAU CLAIRE WI
54703-3467
US

V. Phone/Fax

Practice location:
  • Phone: 218-720-3787
  • Fax: 218-722-4003
Mailing address:
  • Phone: 715-831-8966
  • Fax: 715-831-8968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2739
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: