| NPI | 1760685143 |
|---|---|
| Doing Business As | CANNON FAMILY PRACTICE - EASTSIDE |
| Entity Type | Organization |
| Authorized Contact | NORMAN GENE RENTZ CEO 864-878-4791 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2010-07-20 |