Provider Demographics
NPI:1770182594
Name:CONLEY, JOSHUA TYLER
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:TYLER
Last Name:CONLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 SKEENS AVENUE
Mailing Address - Street 2:
Mailing Address - City:VERDUNVILLLE
Mailing Address - State:WV
Mailing Address - Zip Code:25649
Mailing Address - Country:US
Mailing Address - Phone:304-688-4233
Mailing Address - Fax:
Practice Address - Street 1:44 SKEENS AVENUE
Practice Address - Street 2:
Practice Address - City:VERDUNVILLLE
Practice Address - State:WV
Practice Address - Zip Code:25649
Practice Address - Country:US
Practice Address - Phone:304-688-4233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant