Healthcare Provider Details

I. General information

NPI: 1336632314
Provider Name (Legal Business Name): RHONDA C CONNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 34TH ST NW
CANTON OH
44709-2862
US

IV. Provider business mailing address

3226 ORCHARDVIEW DR SE
CANTON OH
44730-9401
US

V. Phone/Fax

Practice location:
  • Phone: 330-412-7240
  • Fax:
Mailing address:
  • Phone: 803-917-3448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: