Individual
MR. CARL KONIECZKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1305 JENNINGS MILL RD STE 110, WATKINSVILLE, GA 30677-7241
(706) 613-5880
Mailing address
3875 JAMAICA DR, JONESBORO, GA 30236-5428
(678) 935-8049
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN210228
GA
Other
Enumeration date
04/26/2013
Last updated
08/16/2022
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