Canon Professional, L.l.c.
NPI #1568625549 in Canon City, Colorado
Provider Information
- NPI Number
- 1568625549
- Entity Type
- Organization
- Organization Name
- Canon Professional, L.l.c.
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Jul 9, 2008
- Last Updated
- Jul 9, 2008
Practice Location
- Address
- 730 MACON AVE
- City
- Canon City
- State
- Colorado
- ZIP Code
- 81212-3314
- Phone
- (719) 275-1618
Authorized Official
- Name
- DR. GARY ALAN MOHR, M.D.
- Title
- OWNER
- Phone
- (719) 275-1618
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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