Individual
LAWRENCE M KOVALCIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3700 KOLBE RD, LORAIN, OH 44053-1611
(440) 960-3000
Mailing address
51820 BETTS RD, WELLINGTON, OH 44090-9728
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50000818
OH
Other
Enumeration date
06/01/2006
Last updated
12/30/2007
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