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Individual

DAVID CANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
3200 S AIRPORT RD W, #146, TRAVERSE CITY, MI 49684-8117
(231) 941-5440
(231) 941-0893
Mailing address
3200 S AIRPORT RD W, #146, TRAVERSE CITY, MI 49684-8117
(231) 941-5440
(231) 941-0893

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
DC00295
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3278492
MI
Enumeration date
12/15/2005
Last updated
07/29/2011
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