Individual
CONNOR PASSALACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8423 MARKET ST STE 207, BOARDMAN, OH 44512-6778
(330) 729-8700
Mailing address
966 BARTLEY ST, JASPER, IN 47546-2641
(812) 996-7810
(812) 996-8465
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
—
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2022
Last updated
06/26/2025
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