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Individual

ABREAH E CANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
8000 MADISON BLVD, MADISON, AL 35758-2031
(256) 461-6903
Mailing address
1130 NANCE RD, MADISON, AL 35757-7716
(563) 370-9194

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20561
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20561
PHARMACIST LICENSE NUMBER
Enumeration date
04/29/2022
Last updated
04/29/2022
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