Individual
JASON KONECHNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4629 E RYAN PKWY, BELOIT, WI 53511-4109
(716) 572-5629
Mailing address
4629 E RYAN PKWY, BELOIT, WI 53511-4109
(716) 572-5629
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1127-039
WI
Other
Enumeration date
11/09/2022
Last updated
11/09/2022
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