Individual
ERICA CONERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED HAIR LOSS
Contact information
Practice address
244 STONEFIELD CIR, MACON, GA 31216-6286
(478) 390-4025
Mailing address
244 STONEFIELD CIR, MACON, GA 31216-6286
(478) 390-4025
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO115595
GA
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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