Healthcare Provider Details

I. General information

NPI: 1265495022
Provider Name (Legal Business Name): KAREN W. KOVACS PT, MS PT, OCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7190 CHAPMAN DR
HAYES VA
23072-3416
US

IV. Provider business mailing address

350 NEW FIDELITY CT
GARNER NC
27529-2665
US

V. Phone/Fax

Practice location:
  • Phone: 800-464-2302
  • Fax: 804-642-3467
Mailing address:
  • Phone: 919-258-2714
  • Fax: 757-873-2306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305203990
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: