Provider Demographics
NPI:1922538313
Name:KOVALESKI, ZACHARY (PTA)
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:
Last Name:KOVALESKI
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 SAVORY LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-1495
Mailing Address - Country:US
Mailing Address - Phone:570-614-3152
Mailing Address - Fax:
Practice Address - Street 1:540 MOUNT HOLLY MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-4390
Practice Address - Country:US
Practice Address - Phone:704-323-3337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA6526225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant