Individual
ALYSSA DANIELLE CONJACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
300 STATE ST, ERIE, PA 16507-1427
(144) 540-6048
Mailing address
110 CONN TER STE 550, LEXINGTON, KY 40508-3206
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2085DT
KY
Other
Enumeration date
04/17/2017
Last updated
03/11/2020
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