Organization
CANON PROFESSIONAL, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY ALAN MOHR M.D. (OWNER)
(719) 275-1618
Entity
Organization
Contact information
Practice address
730 MACON AVE, CANON CITY, CO 81212-3314
(719) 275-1618
(719) 275-7334
Mailing address
730 MACON AVE, CANON CITY, CO 81212-3314
(719) 275-1618
(719) 275-7334
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
24731
CO
Other
Enumeration date
07/09/2008
Last updated
07/09/2008
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