Individual
TAESHA CONLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
509 VININGS CRST SE, SMYRNA, GA 30080-4697
(612) 207-3836
Mailing address
509 VININGS CRST SE, SMYRNA, GA 30080-4697
(612) 207-3836
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
23-276324
GA
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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