NPI 1073615589
Stephen Dale Gannaway, MA
Practice location
- Address
- 3143 W Jefferson St, Joliet, IL 60435-4733
- Phone
- (815) 744-6898
- Fax
- (815) 744-2486
- Mailing address
- 6 Victory Drive, Liberty, MO 64068
Registered specialties
Audiologist-Hearing Aid Fitter
Primary
Registry record
- NPI
- 1073615589
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 4 Sep 2006
- Record last updated
- 26 Mar 2013
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.