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Individual

JODI A CONLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
100 BELLEFONTE DR, GRAYSON, KY 41143-1820
(606) 474-0669
(606) 474-0376
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-6612

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA355
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1071595
BRICKSTREET/WV COMP
WV
05
7100055310
KY
Enumeration date
11/21/2006
Last updated
05/19/2020
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