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General NPI Number Information
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NPI Number | 1306584289
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Entity Type | Organization
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Legal Business Name | KOVSA WELLNESS LLC
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Dates
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Enumeration Date | 05/22/2022
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 201 S MAIN ST
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City | LAMBERTVILLE
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State | NJ
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Zip | 08530-1800
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Country | US
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Telephone | 609-460-4574
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Fax |
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Provider Business Mailing Address
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Address Line | 359 SNOWBALL DR
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City | LEVITTOWN
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State | PA
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Zip | 19056-1721
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OLGA KOVALYOVA-SAXMAN
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Credential | LMT, NMT
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Telephone | 404-610-3013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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