Individual
JOHN KONOPKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
485 EMERSON DR, MYRTLE BEACH, SC 29579-5291
(843) 424-1690
Mailing address
485 EMERSON DR, MYRTLE BEACH, SC 29579-5291
(843) 424-1690
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2472
SC
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
2472
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH1581
—
SC
Enumeration date
06/12/2006
Last updated
02/07/2020
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