Individual
GEORGE ROBERT CANNON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 N MAIN ST, ENTERPRISE, AL 36330-2537
(334) 347-2506
Mailing address
112 N MAIN ST, ENTERPRISE, AL 36330-2537
(334) 347-2506
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6979
AL
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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