TIMOTHY WADE CANNON

AMMON, ID
NPI1952722290
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy111N00000X Chiropractor
(Licence: ID  CHIA-1580)
Enumeration Date2014-01-03
Last Update Date2017-02-09
Business Address
TIMOTHY WADE CANNON D.C.
611 ENSIGN DR
AMMON, ID 83406-4777
Phone number: 208-557-1880
Mailing Address
TIMOTHY WADE CANNON D.C.
611 ENSIGN DR
AMMON, ID 83406-4777
Phone number: 208-557-1880
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