Healthcare Provider Details

I. General information

NPI: 1902097991
Provider Name (Legal Business Name): MARK E KOWALSKI CHIROPRACTOR DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6151 AVERY RD STE B
DUBLIN OH
43016-9614
US

IV. Provider business mailing address

6151 AVERY RD STE B
DUBLIN OH
43016-9614
US

V. Phone/Fax

Practice location:
  • Phone: 614-975-4579
  • Fax: 614-798-8018
Mailing address:
  • Phone: 614-975-4579
  • Fax: 614-798-8018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1148
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: