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1619493897
KRYSTAL CANNON
MOUNT VERNON, OH
NPI
1619493897
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: OH W.1700001)
Enumeration Date
2017-08-18
Last Update Date
2020-07-15
Business Address
KRYSTAL CANNON SWA, QMHS
8402 BLACKJACK RD
MOUNT VERNON, OH 43050-9193
Phone number: 740-397-0442
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Mailing Address
KRYSTAL CANNON SWA, QMHS
8402 BLACKJACK RD
MOUNT VERNON, OH 43050-9193
Phone number: 740-485-6229
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