Individual
COURTNEY KOPPENAL KOVALICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3840 ED DR, SUITE 111, RALEIGH, NC 27612-8005
(919) 571-3661
Mailing address
3840 ED DR, SUITE 111, RALEIGH, NC 27612-8005
(919) 571-3661
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-01066
NC
Other
Enumeration date
12/26/2007
Last updated
01/07/2013
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