Individual
TIMOTHY KOWALCZYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CTRS, CBIS
Contact information
Practice address
1358 LEVONA ST, YPSILANTI, MI 48198-6440
(734) 972-0126
Mailing address
1358 LEVONA ST, YPSILANTI, MI 48198-6440
(734) 972-0126
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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