Provider Information for 1205029592
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CHRISTOPHER CONLEY
Sex: Male
NPI: 1205029592
Last Updated: 2022-12-02
Certification Date: 2022-12-02
Certification Date: 2022-12-02
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1205029592 | ||||||||||||
| Enumeration Date | 2007-08-21 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 10299 FORT WAYNE, IN 46851-0299 United States Phone: 574-546-1900 | Fax: | ||||||||||||
| Primary Practice Address | 4400 EASTON CMNS STE 125 COLUMBUS, OH 43219-6223 United States Phone: 574-546-1900 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 306 W MAIN ST STE 512 | ||||||||||||
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