Individual
LIESL MARIE CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1005 W. RALPH HALL PKWY, SUITE 201, ROCKWALL, TX 75032-6662
(972) 771-9081
Mailing address
1005 W. RALPH HALL PKWY, SUITE 201, ROCKWALL, TX 75032-6662
(972) 771-9081
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA05675
TX
Other
Enumeration date
02/06/2008
Last updated
07/29/2008
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