Organization
INTEGRATED MEDICINE: CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS CANNON DC (OWNER/)
(802) 458-0488
Entity
Organization
Contact information
Practice address
1641 ROUTE 7 S, MIDDLEBURY, VT 05753-8806
(802) 458-0488
(802) 458-0489
Mailing address
PO BOX 705, EAST MIDDLEBURY, VT 05740-0705
(802) 458-0488
(802) 458-0489
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
006-0001191
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015096
—
VT
Enumeration date
03/22/2011
Last updated
03/22/2011
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