Provider Demographics
NPI:1134340284
Name:CONNEALY, ALAN PATRICK (DC)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:PATRICK
Last Name:CONNEALY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 STEINER ST.
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2219
Mailing Address - Country:US
Mailing Address - Phone:913-669-8023
Mailing Address - Fax:
Practice Address - Street 1:1801 BUSH ST.
Practice Address - Street 2:#30
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5284
Practice Address - Country:US
Practice Address - Phone:415-351-0716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5724111N00000X
CT001621111N00000X
KS0104945111N00000X
CADC30583111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor