Individual
WILLIAM CONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21260 N 1450 E, 21260 NORTH 1450 EAST, MORONI, UT 84646-0383
(435) 851-6821
Mailing address
21260 N 1450 E, MORONI, UT 84646
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
139432-3501
UT
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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