MEDICARE: JOSEPH A KONOPKA DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0104000172	VA

General Provider Information

NPI Number	:	1558361022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH A KONOPKA DC

Provider Business Mailing Address
First Line	:	PO BOX 2427
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22195-2427
Country	:	US
Telephone Number	:	703-878-3232
Fax Number	:	703-878-3232

Provider Business Practice Location Address
First Line	:	4343 RIDGEWOOD CENTER DR
Second Line	:	SUITE B-1
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-5308
Country	:	US
Telephone Number	:	703-878-3232
Fax Number	:	703-878-3232

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	07/08/2007

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Directions to “ JOSEPH A KONOPKA DC” Practice Location

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