Timothy Wade Cannon, D.C.

NPI #1952722290 in Ammon, Idaho

Provider Information

NPI Number: 1952722290
Entity Type: Individual
Name: Timothy Wade Cannon, D.C.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Chiropractor
Credential: D.C.
Enumeration Date: Jan 3, 2014
Last Updated: Feb 9, 2017

Practice Location

Address: 611 ENSIGN DR
City: Ammon
State: Idaho
ZIP Code: 83406-4777
Phone: (208) 557-1880

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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