Individual
MR. CHUCK CONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.A.T., A.T.C.
Contact information
Practice address
1500 N PATTERSON ST, VALDOSTA STATE UNIVERSITY, DEPT. KSPE, VALDOSTA, GA 31698-0100
(229) 333-5354
Mailing address
2951 FINDLEY CHASE, VALDOSTA, GA 31605-6528
(229) 244-9386
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000506
GA
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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