Most Relevant Information
Provider Data
  | NPI Number: | 1003592809 | 
| Provider Name: | CONDI NEACE | 
| Entity Type: | Individual | 
| Taxonomy Code: | 101YM0800X | 
| Specialty: | Counselor | 
| License Number: | 
Most Important Dates
  | Enumeration Date: | 06/26/2023 | 
| Last Updated: | 06/26/2023 | 
Provider Practice Location
  104 S FRONT AVE
      
      PRESTONSBURG
      KY
      416531614
  Practice Location Phone/Fax
      | Phone: | 6068868572 | 
| Fax: | 6068864433 | 
Provider Mailing Location
  104 S FRONT AVE
      
      PRESTONSBURG
      KY
      416531614
  Provider Mailing Phone/Fax
      | Phone: | 6068868572 | 
| Fax: | 6068864433 |