Individual
MR. BRYANT CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
544 E OGDEN AVE, 700-265, MILWAUKEE, WI 53202-2698
(414) 745-1737
Mailing address
544 E OGDEN AVE, 700-265, MILWAUKEE, WI 53202-2698
(414) 745-1737
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
VN188908
CA
Other
Enumeration date
09/08/2007
Last updated
09/08/2007
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