Individual
MARIA GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
212 LAFAYETTE AVE, STORY CITY, IA 50248-1454
(515) 733-4325
Mailing address
4630 TWAIN ST, AMES, IA 50014-8127
(319) 631-8993
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
—
—
Other
Enumeration date
05/18/2019
Last updated
05/18/2019
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