Healthcare Provider Details

I. General information

NPI: 1285166751
Provider Name (Legal Business Name): LINKA CONKLE BC-HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 BETHESDA DR DOCTORS PARK 1
ZANESVILLE OH
43701-1895
US

IV. Provider business mailing address

830 BETHESDA DR DOCTORS PARK 1
ZANESVILLE OH
43701-1895
US

V. Phone/Fax

Practice location:
  • Phone: 740-450-7660
  • Fax: 740-450-7675
Mailing address:
  • Phone: 740-450-7660
  • Fax: 740-450-7675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2784
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: