Individual
TRACY KONOPACKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, LAT
Contact information
Practice address
1111 DELAFIELD ST, SUITE 120, WAUKESHA, WI 53188-3417
(262) 544-5311
Mailing address
1111 DELAFIELD ST, SUITE 120, WAUKESHA, WI 53188-3417
(262) 544-5311
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
795039
WI
Other
Enumeration date
01/19/2011
Last updated
01/19/2011
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