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General NPI Number Information
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NPI Number | 1316596638
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Entity Type | Individual
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Provider Name | KATHERINE A KOWALCZYK PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 131 RACINE DR STE 201
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City | WILMINGTON
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State | NC
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Zip | 28403-8752
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Country | US
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Telephone | 910-362-9405
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Fax |
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Provider Business Mailing Address
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Address Line | 65 E WADSWORTH PARK DR STE 230
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City | DRAPER
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State | UT
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Zip | 84020-8096
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Country | US
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Telephone | 853-308-8034
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Fax | 808-657-3222
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PT35121
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT35121
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License Number State | FL
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