Individual
DEREK CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1114 E MAIN ST, BROWNSVILLE, TN 38012-2621
(731) 772-1170
Mailing address
1114 RUSTLING OAKS DR, PLEASANT VIEW, TN 37146-7046
(615) 415-4646
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
38490
TN
Other
Enumeration date
08/13/2014
Last updated
03/15/2020
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