Individual
GINA A CANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2777 MILE HIGH STADIUM CIR, DENVER, CO 80211-5222
(303) 825-8822
(303) 825-4022
Mailing address
2777 MILE HIGH STADIUM CIR, DENVER, CO 80211-5222
(303) 825-8822
(303) 825-4022
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2088
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84158239
—
CO
Enumeration date
08/30/2006
Last updated
01/28/2011
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