Provider Demographics
NPI:1447982921
Name:KOWALSKI, ANN (PT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 WINDINGWAY DR
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-1151
Mailing Address - Country:US
Mailing Address - Phone:248-701-7819
Mailing Address - Fax:
Practice Address - Street 1:26105 ORCHARD LAKE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4576
Practice Address - Country:US
Practice Address - Phone:248-615-0852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501005364225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1968OtherCOMMERCIAL, PROVATE INSURANCES