Individual
CONNER ALAN SHOWALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
707 MOUNT CROSS RD, DANVILLE, VA 24540-5905
(434) 791-5700
Mailing address
204 BRIGHTWELL CT, DANVILLE, VA 24540-3416
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XXX-XX-4019
TRI-CARE PRIME
NC
Enumeration date
08/04/2017
Last updated
08/04/2017
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