Individual
BENJAMIN MORRIS GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
810 E 23RD ST, SIOUX FALLS, SD 57105-2135
(605) 331-5890
Mailing address
1112 W 27TH ST, SIOUX FALLS, SD 57105-2707
(510) 220-7760
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0724
SD
Other
Enumeration date
01/30/2017
Last updated
09/11/2024
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