Provider Demographics
NPI:1366229916
Name:CONERLY, AMBER (DC)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:CONERLY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5560 RIVERSIDE DR
Mailing Address - Street 2:APT 3202
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210
Mailing Address - Country:US
Mailing Address - Phone:256-614-9600
Mailing Address - Fax:
Practice Address - Street 1:113 CARL VINSON PKWY STE A
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-5817
Practice Address - Country:US
Practice Address - Phone:478-225-9840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO11065111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor