Individual
SUSAN DEBORAH KONKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1335 S ONEIDA ST, APPLETON, WI 54915-1351
(920) 731-6646
Mailing address
1335 S ONEIDA ST, APPLETON, WI 54915-1351
(920) 731-6646
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
530-019
WI
Other
Enumeration date
06/26/2013
Last updated
10/25/2018
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