Individual
R L CONERLY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(800) 517-6935
Mailing address
PO BOX 666, COLUMBIA, MS 39429-0666
(601) 441-9165
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2379
MS
225X00000X
Occupational Therapist
OT1963
MS
Other
Enumeration date
04/23/2007
Last updated
09/11/2025
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