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General NPI Number Information
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NPI Number | 1285961821
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Entity Type | Organization
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Legal Business Name | JOHN S KOVAR DC PA
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 11/03/2009
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Provider Practice Location Address
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Address Line | 29G MIRACLE STRIP PKWY SW
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City | FORT WALTON BEACH
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State | FL
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Zip | 32548-6655
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Country | US
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Telephone | 850-244-1200
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Fax | 850-664-2170
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Provider Business Mailing Address
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Address Line | 29G MIRACLE STRIP PKWY SW
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City | FORT WALTON BEACH
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State | FL
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Zip | 32548-6655
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Country | US
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Telephone | 850-244-1200
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Fax | 850-664-2170
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN S KOVAR
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Credential | D.C.
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Telephone | 850-244-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH3886
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License Number State | FL
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