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NPI Code Detail

MEDICARE: CRAIG CONLEY

MEDICARE: CRAIG CONLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantPTA010199OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AB7360731OTHEROHMEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376992032
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG CONLEY
Provider Business Mailing Address
First Line : 7591 TYLERS PLACE BLVD
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-6308
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3817 COLONEL GLENN HWY
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45324-2031
Country : US
Telephone Number : 937-427-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2016
Last Update Date : 03/17/2018

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Directions to “ CRAIG CONLEY ” Practice Location

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