NICHOLAS GANNON

STOCKTON, CA
NPI1326620014
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: CA  20A20458)
Enumeration Date2021-04-22
Last Update Date2023-01-29
Business Address
NICHOLAS GANNON DO
1800 N CALIFORNIA ST
STOCKTON, CA 95204-6019
Phone number: 209-547-5716
Mailing Address
NICHOLAS GANNON DO
1800 N CALIFORNIA ST
STOCKTON, CA 95204-6019
Phone number: