Individual
MRS. JACQUELINE LEE KOWALCZYK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
2900 BURLINGAME AVE SW, WYOMING, MI 49509-2610
(616) 538-1490
Mailing address
3878 TALL OAK CT SW, GRAND RAPIDS, MI 49534-6685
(616) 453-6586
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302025887
MI
Other
Enumeration date
01/07/2006
Last updated
07/08/2007
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