Individual
RHETTA A CONN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
412 CENTRAL AVE, COLDWATER, MS 38618-3843
(662) 622-5173
(662) 622-5590
Mailing address
PO BOX 486, 412 CENTRAL AVENUE, COLDWATER, MS 38618-0486
(662) 622-5173
(662) 622-5590
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
806
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02623217
—
MS
01
—
12077069
CAQH
—
Enumeration date
07/31/2009
Last updated
03/07/2023
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