Individual
MRS. LAURA SUSANNE KOVACIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
6005 MONCLOVA RD, MAUMEE, OH 43537-1864
(419) 893-2663
(419) 893-7240
Mailing address
646 MARILYN DR, ROSSFORD, OH 43460-1512
(419) 304-0692
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
OH
Other
Enumeration date
05/23/2017
Last updated
05/23/2017
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