Organization
CANYON MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB WELCH (MEMBER)
(573) 281-2103
Entity
Organization
Contact information
Practice address
100 E MAIN ST, MALDEN, MO 63863-2214
(573) 281-2103
(573) 281-2168
Mailing address
100 E MAIN ST, MALDEN, MO 63863-2214
(573) 281-2103
(573) 281-2168
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/03/2025
Last updated
10/07/2025
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