Individual
KELLY D KOVACIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
17 E RIVER ST STE A, NEWTON FALLS, OH 44444-1372
(330) 872-7242
Mailing address
PO BOX 392573, PITTSBURGH, PA 15251-4084
(724) 343-4060
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
09059
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000198483
ANTHEM
OH
05
—
2278762
—
OH
01
—
6500222996
MEDICARE RAILROAD
OH
Enumeration date
11/09/2005
Last updated
10/07/2024
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