Individual
CONNER HART CHICOINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6945 OLD HIGHWAY 53, CLEARLAKE, CA 95422-9381
(707) 995-9523
Mailing address
1152 S MAIN ST, LAKEPORT, CA 95453-5517
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/13/2022
Last updated
05/13/2022
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