Jacob (jake) William Condren, PA-C

NPI #1265971865 in Bolivar, Missouri

Provider Information

NPI Number: 1265971865
Entity Type: Individual
Name: Jacob (jake) William Condren, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Feb 15, 2017
Last Updated: Feb 15, 2017

Practice Location

Address: 1155 W PARKVIEW ST
Address 2: SUITE 2D
City: Bolivar
State: Missouri
ZIP Code: 65613-8279
Phone: (417) 777-2663

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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