| Doctor Name: | KURT KRIZTOFER KOVALOVICH |
| NPI Number: | 1316945496 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | SC003328R |
| Business Practice Address: | 185 S Tulpehocken St Pine Grove, PA - 179631029 |
| Business Phone Number: | 5703456301 |
| Business Fax Number: | 5703452626 |
| Mailing Address: | Po Box 167, 185 S Tulpehocken St PINE GROVE |
| State: | PA |
| Postal Code: | 179630167 |
| Phone Number: | 5703456301 |
| Fax Number: | 5703452626 |
| NPI Enumeration Date: | 07/12/2005 |
| NPI Last Update Date: | 11/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | SC003328R |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |