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Individual

DR. BENJAMIN DAVID CONNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
4345 ATLANTA HWY, BUS 6, HIRAM, GA 30141
(770) 505-2880
(770) 505-2889
Mailing address
4345 ATLANTA HWY, BUS 6, HIRAM, GA 30141
(770) 505-2880
(770) 505-2889

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR007889
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202I351697
MEDICARE PTAN
GA
Enumeration date
10/16/2007
Last updated
01/10/2012
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