Individual
BRANDON JOHN KOVASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
710 PARK CENTER DR STE 200, MATTHEWS, NC 28105-5082
(704) 323-3208
Mailing address
PO BOX 601791, CHARLOTTE, NC 28260-1791
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P18251
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
BCBS
NC
05
—
PENDING
—
NC
Enumeration date
08/17/2018
Last updated
12/17/2024
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