Individual
WENDY JO KOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
255 SMITH AVE N, SUITE 100, SAINT PAUL, MN 55102-2572
(651) 726-2753
Mailing address
9861 ILEX ST NW, COON RAPIDS, MN 55433-5445
(763) 205-3708
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R 113682-1
MN
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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