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General NPI Number Information
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NPI Number | 1518149558
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Entity Type | Organization
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Legal Business Name | WAYNE P. CONLON & LAURIE J. CONLON, PTNRS
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Dates
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Enumeration Date | 12/01/2007
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Last Update Date | 12/01/2007
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Provider Practice Location Address
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Address Line | 5759 SE FEDERAL HWY
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City | STUART
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State | FL
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Zip | 34997-8545
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Country | US
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Telephone | 772-220-9565
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Fax | 772-220-0964
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Provider Business Mailing Address
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Address Line | 5759 SE FEDERAL HWY
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City | STUART
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State | FL
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Zip | 34997-8545
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Country | US
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Telephone | 772-220-9565
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Fax | 772-220-0964
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. WAYNE PETER CONLON
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Credential | DC
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Telephone | 772-220-9565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH7972
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License Number State | FL
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