Individual
JENNIFER GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
4151 S CANTON CENTER RD, CANTON, MI 48188-2489
(734) 394-0027
Mailing address
20450 WILMOT RD, BELLEVILLE, MI 48111-9425
(734) 461-4824
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302030891
MI
Other
Enumeration date
03/18/2007
Last updated
07/08/2007
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