Individual
GARY SEAN KONCEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1805 VERNON RD, LAGRANGE, GA 30240-3871
(706) 845-9383
(706) 845-9382
Mailing address
8059 MITCHELL LN, BIRMINGHAM, AL 35216
(706) 845-9383
(706) 845-9382
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011426
GA
Other
Enumeration date
05/13/2014
Last updated
07/05/2023
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