Individual
MICHELLE IRENE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1480 W WATERFRONT DR, SYRACUSE, UT 84075-3803
(509) 330-0878
Mailing address
1480 W WATERFRONT DR, SYRACUSE, UT 84075-3803
(509) 330-0878
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
13954808-4901
UT
Other
Enumeration date
01/31/2025
Last updated
01/31/2025
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