Individual
JERIS CLAY PORTER CANNADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
4455 E 12TH AVE, DENVER, CO 80220-2415
(303) 504-7847
Mailing address
4455 E 12TH AVE, DENVER, CO 80220-2415
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
CO
Other
Enumeration date
05/12/2023
Last updated
05/12/2023
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