Individual
MATT KOWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6085 SUNNYFIELD RD E, MINNETRISTA, MN 55364-8254
(612) 227-3199
Mailing address
PO BOX 579, MOUND, MN 55364-0579
(612) 227-3199
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
MN
Other
Enumeration date
01/03/2009
Last updated
01/03/2009
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