Colleen M Canavan, PA
NPI #1205090644 in Jerseyville, Illinois
Provider Information
- NPI Number
- 1205090644
- Entity Type
- Individual
- Name
- Colleen M Canavan, PA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA
- Enumeration Date
- Jul 15, 2008
- Last Updated
- Sep 21, 2016
Practice Location
- Address
- 390 MAPLE SUMMIT RD
- City
- Jerseyville
- State
- Illinois
- ZIP Code
- 62052-2000
- Phone
- (618) 498-2101
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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