Individual
CONRAD WALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3700 W 10TH ST STE 100, SEDALIA, MO 65301-2540
(660) 827-2883
Mailing address
147 SYCAMORE ST, PIKEVILLE, KY 41501-9118
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/15/2026
Last updated
06/15/2026
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