Individual
CANNON L TUBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1243 GAYLORD ST, 106, DENVER, CO 80206-2919
(210) 288-4256
Mailing address
1243 GAYLORD ST, 106, DENVER, CO 80206-2919
(210) 288-4256
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
711064
TX
Other
Enumeration date
10/06/2010
Last updated
10/06/2010
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