Cannon Therapy | |
2909 Bent Ave Cheyenne WY 82001-2742 | |
(970) 290-9897 | |
Not Available |
Full Name | Cannon Therapy |
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Speciality | Clinic/Center |
Location | 2909 Bent Ave, Cheyenne, Wyoming |
Authorized Official Name and Position | Gregory V Stelzner (OWNER) |
Authorized Official Contact | 9702909897 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Cannon Therapy Po Box 20885 Cheyenne WY 82003-7018 Ph: () - | Cannon Therapy 2909 Bent Ave Cheyenne WY 82001-2742 Ph: (970) 290-9897 |
NPI Number | 1841947926 |
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Provider Enumeration Date | 03/08/2022 |
Last Update Date | 03/08/2022 |
Medicare PECOS PAC ID | 9638558869 |
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Medicare Enrollment ID | O20220620000035 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841947926 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Gregory V Stelzner |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1003179649 PECOS PAC ID: 5092022608 Enrollment ID: I20150915001365 |
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