Individual
DR. BROOKE NICOLE JONES-CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
210 ROGOSIN DR, ELIZABETHTON, TN 37643-2906
(423) 543-6868
(423) 543-4226
Mailing address
210 ROGOSIN DR, ELIZABETHTON, TN 37643-2906
(423) 543-6868
(423) 543-4226
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT3491
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891831160
—
TN
Enumeration date
07/27/2018
Last updated
07/27/2018
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