Individual
MR. MICHAEL STEVEN CANNING JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
862 S MAIN ST, BRIGHAM CITY, UT 84302-3320
(435) 723-2521
Mailing address
862 S MAIN ST, BRIGHAM CITY, UT 84302-3320
(435) 723-2521
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
UT
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
UT
Other
Enumeration date
07/18/2011
Last updated
07/18/2011
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