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Individual
SUSAN R KOWALL
Active
Individual
SUSAN R KOWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
00939
WV
363A00000X
Physician Assistant
Primary
MA050955
PA
Other
Enumeration date
09/15/2006
Last updated
01/27/2009
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