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Individual

MR. KEVIN LESLIE COWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1105 PIMLICO PARK, HOLLAND, OH 43528-8020
(419) 262-7645
Mailing address
1105 PIMLICO PARK, HOLLAND, OH 43528-8020
(419) 262-7645

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
SC172319
OH
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
OH

Other

Enumeration date
06/11/2024
Last updated
06/11/2024
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