# CANONICO EAR, NOSE AND THROAT, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ear, Nose and Throat Associates of Middle Tennessee, P.C.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932177805
- **Authorized official:** TANDIE L MOYERS (OFFICE MANAGER)
- **Authorized official phone:** (931) 684-3504

## Contact information

- **Practice address:** 507 NW ATLANTIC ST, TULLAHOMA, TN 37388-3504
- **Practice address phone:** (931) 393-4332
- **Practice address fax:** (931) 393-2304
- **Mailing address:** 507 NW ATLANTIC ST, TULLAHOMA, TN 37388-3504
- **Mailing address phone:** (931) 393-4332
- **Mailing address fax:** (931) 393-2304

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2006
- **Last updated:** 04/20/2021