Individual
DR. KAITLYNN DONOVAN KOWALICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3701 WAKE FOREST RD, RALEIGH, NC 27609-6832
(919) 350-1508
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P20929
NC
2251P0200X
Pediatric Physical Therapist
872087
DC
2251X0800X
Orthopedic Physical Therapist
CP005111T
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922501188
—
NC
Enumeration date
03/14/2018
Last updated
04/12/2022
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