Individual
MR. ROBERT B CANAAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1900 S DOUGLAS ST APT 2, SALT LAKE CITY, UT 84105-3625
(801) 347-1553
Mailing address
1900 S DOUGLAS ST APT 2, SALT LAKE CITY, UT 84105-3625
(801) 347-1553
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2014-PCA-UT000630
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
901034250002
—
UT
Enumeration date
01/28/2015
Last updated
01/28/2015
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