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Individual
MR. KEVIN KONIECZKA
Active
Individual
MR. KEVIN KONIECZKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11580-24
WI
Other
Enumeration date
04/27/2012
Last updated
07/22/2014
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