MEDICARE: DEBORAH JEAN KOWALSKI DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	547	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0083673	OTHER	TN	BCBS OF TN ID NUMBER

General Provider Information

NPI Number	:	1760524136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH JEAN KOWALSKI DC

Provider Business Mailing Address
First Line	:	108 HARDING PL
Second Line	:	STE 102
City	:	NASHVILLE
State	:	TN
Zip	:	37205-3704
Country	:	US
Telephone Number	:	615-352-1234
Fax Number	:	615-356-1284

Provider Business Practice Location Address
First Line	:	108 HARDING PL
Second Line	:	STE 102
City	:	NASHVILLE
State	:	TN
Zip	:	37205-3704
Country	:	US
Telephone Number	:	615-352-1234
Fax Number	:	615-356-1284

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/08/2007

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