Individual
MS. CARRIE LYNN KOWALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAP, PA-C
Contact information
Practice address
604 ROSE AVENUE, VENICE, CA 90291
(310) 392-8636
Mailing address
604 ROSE AVENUE, VENICE, CA 90291
(310) 392-8636
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA22329
CA
Other
Enumeration date
06/02/2012
Last updated
02/26/2021
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