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Individual

MARYELLA JANE CONLON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
172 E HARBOR, HENDERSONVILLE, TN 37075-3553
(214) 682-6532
Mailing address
172 E HARBOR, HENDERSONVILLE, TN 37075-3553
(214) 682-6532

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11970
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200442370A
OK
Enumeration date
07/18/2012
Last updated
02/09/2021
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