Individual
KELLY ANN KONICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, CLT
Contact information
Practice address
11180 STATE BRIDGE ROAD, SUITE 404, JOHNS CREEK, GA 30022-7482
(678) 871-7940
Mailing address
1405 TREERIDGE PKWY, ALPHARETTA, GA 30022-2830
(917) 304-2672
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT002856
GA
Other
Enumeration date
09/10/2024
Last updated
04/22/2025
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