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Individual

RACHEL MARIE CONYAC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AA

Contact information

Practice address
12 PUEBLO, EDMOND, OK 73013-2036
(405) 626-2826
Mailing address
12 PUEBLO, EDMOND, OK 73013-2036
(405) 626-2826

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
OK
390200000X
Student in an Organized Health Care Education/Training Program
Primary
738
OK

Other

Enumeration date
01/08/2018
Last updated
01/08/2018
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