Individual
MR. GARY PAUL KONECNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
207 N WRIGHT ST, SANTA ANA, CA 92701-5127
(714) 478-5602
Mailing address
207 N WRIGHT ST, SANTA ANA, CA 92701-5127
(714) 478-5602
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT22121
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT22121
PT LICENCE NUMBER
CA
Enumeration date
12/08/2006
Last updated
07/08/2007
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