Individual
ALICIA ANNETTE CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, PA-C
Contact information
Practice address
420 W ACACIA ST STE 1, STOCKTON, CA 95203-2441
(209) 948-1583
Mailing address
1700 N TULLY RD APT E148, TURLOCK, CA 95380-6853
(916) 601-4696
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA57581
CA
Other
Enumeration date
10/18/2018
Last updated
09/25/2020
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