Individual
OLIVIA JEAN KOVARIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226
(414) 266-2625
(414) 266-2635
Mailing address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-2625
(414) 266-2635
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4573-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043784127
—
WI
Enumeration date
01/11/2019
Last updated
03/27/2019
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