Individual
TYSHAWN CONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
502 BOOTH RD, WARNER ROBINS, GA 31088-3422
(478) 918-0636
(478) 918-0683
Mailing address
502 BOOTH RD, WARNER ROBINS, GA 31088-3422
(478) 918-0636
(478) 918-0683
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO002698
GA
Other
Enumeration date
05/29/2023
Last updated
05/29/2023
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