Individual
WILLIAM S CONNOLLY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
420 S JACKSON ST, POTTSVILLE, PA 17901-3625
(570) 621-5325
(570) 621-5806
Mailing address
450 WASHINGTON ST, BOX 9, POTTSVILLE, PA 17901-3655
(570) 621-5018
(570) 621-5806
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OS002643L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009230310005
—
PA
Enumeration date
09/21/2005
Last updated
07/08/2007
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