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Individual

DR. KRISTINA MARIE KOVACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
15800 DETROIT AVE, LAKEWOOD, OH 44107-3748
(216) 227-2194
(216) 227-2196
Mailing address
PO BOX 639004, CINCINNATI, OH 45263-9004
(440) 895-5056
(440) 333-2935

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002928
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2035158
OH
01
P00351773
RRCARE
OH
Enumeration date
08/30/2005
Last updated
06/11/2019
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