Amy Gannon

NPI #1639616477 in Wakefield, Rhode Island

Provider Information

NPI Number: 1639616477
Entity Type: Individual
Name: Amy Gannon
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Health Worker
Enumeration Date: Jan 31, 2017
Last Updated: Jan 31, 2017

Practice Location

Address: 201 MIDDLEBRIDGE RD
City: Wakefield
State: Rhode Island
ZIP Code: 02879-7105
Phone: (860) 817-6905

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X	Primary

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