Organization
CANON ANESTHESIA SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY MCMILLEN (PRESIDENT)
(719) 276-2029
Entity
Organization
Contact information
Practice address
933 SELLS AVE, CANON CITY, CO 81212-4900
(719) 275-6433
Mailing address
8022 GARDEN PARK RD, CANON CITY, CO 81212-4900
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
45130
CO
Other
Enumeration date
07/12/2006
Last updated
08/22/2020
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