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General NPI Number Information
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NPI Number | 1306915343
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Entity Type | Individual
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Provider Name | WENDY A KONICK DC
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9535 RESEDA BLVD SUITE 212
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City | NORTHRIDGE
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State | CA
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Zip | 91324
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Country | US
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Telephone | 818-886-8018
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Fax | 818-831-3448
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Provider Business Mailing Address
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Address Line | 16251 MINNEHAHA ST SUITE
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City | GRANADA HILLS
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State | CA
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Zip | 91344-6837
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Country | US
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Telephone | 818-831-3448
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Fax | 818-831-3448
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC26093
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License Number State | CA
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