Individual
BRANDON GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1405 N 205TH ST STE 140, ELKHORN, NE 68022-4740
(402) 289-5013
Mailing address
850 43RD AVE STE 100, MOLINE, IL 61265-8401
(309) 743-2070
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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