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General NPI Number Information
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NPI Number | 1326769878
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Entity Type | Organization
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Legal Business Name | WILSON, CONKEY & ASSOCIATES, P.C.
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Dates
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Enumeration Date | 09/02/2022
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Last Update Date | 09/02/2022
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Provider Practice Location Address
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Address Line | 9730 S MCCARRAN BLVD STE 1
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City | RENO
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State | NV
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Zip | 89523-9215
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Country | US
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Telephone | 775-787-3939
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Fax | 775-746-3991
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Provider Business Mailing Address
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Address Line | 620 SIERRA ROSE DR
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City | RENO
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State | NV
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Zip | 89511-2072
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Country | US
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Telephone | 775-689-4519
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL WILSON
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Credential | OD
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Telephone | 775-689-4519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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