Healthcare Provider Details

I. General information

NPI: 1760524136
Provider Name (Legal Business Name): DEBORAH JEAN KOWALSKI DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 HARDING PL STE 102
NASHVILLE TN
37205-3704
US

IV. Provider business mailing address

108 HARDING PL STE 102
NASHVILLE TN
37205-3704
US

V. Phone/Fax

Practice location:
  • Phone: 615-352-1234
  • Fax: 615-356-1284
Mailing address:
  • Phone: 615-352-1234
  • Fax: 615-356-1284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number547
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: