Individual
MR. KEVIN KONIECZKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1224 MILLER PARKWAY, MILWAUKEE, WI 53214
(414) 847-2971
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11580-24
WI
Other
Enumeration date
04/27/2012
Last updated
07/22/2014
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