IAN KEVIN GANNON

LUBBOCK, TX
NPI1235874165
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: TX  241330)
Enumeration Date2022-05-04
Last Update Date2022-05-04
Business Address
IAN KEVIN GANNON COTA
4510 IRONTON AVE APT 12206
LUBBOCK, TX 79407-3816
Phone number: 806-577-6706
Mailing Address
IAN KEVIN GANNON COTA
4403 74TH ST
LUBBOCK, TX 79424-2307
Phone number: