Individual
BONNIE M CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
1899 HIGHWAY 63, WESTPHALIA, MO 65085-2215
(615) 896-6400
Mailing address
1330 SCHNEIDER RD, BLAND, MO 65014-2308
(615) 896-6400
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2001010113
MO
Other
Enumeration date
03/03/2009
Last updated
03/03/2009
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