Individual
BRANDON KOWACICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1305 MESQUITE TRL, BENBROOK, TX 76126-3811
(417) 522-4098
Mailing address
1305 MESQUITE TRL, BENBROOK, TX 76126-3811
(417) 522-4098
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2092157
TX
Other
Enumeration date
12/18/2014
Last updated
12/18/2014
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