Healthcare Provider Details

I. General information

NPI: 1346628666
Provider Name (Legal Business Name): PAULA KOWALSKI D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2015
Last Update Date: 05/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 6TH AVE STE A
KEARNEY NE
68845-3393
US

IV. Provider business mailing address

4010 6TH AVE STE A
KEARNEY NE
68845-3393
US

V. Phone/Fax

Practice location:
  • Phone: 308-455-1410
  • Fax: 308-455-1411
Mailing address:
  • Phone: 308-455-1410
  • Fax: 308-455-1411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1846
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: