Individual
DR. CHAD JACOB CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
14244 POTRANCO RD STE 250, SAN ANTONIO, TX 78253-2145
(435) 755-7654
(435) 753-7654
Mailing address
PO BOX 700688, SAN ANTONIO, TX 78270-0688
(210) 318-3007
(210) 468-0682
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
7875588-1202
UT
111NR0400X
Rehabilitation Chiropractor
Primary
15645
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15645
CHIROPRACTIC LICENSE
TX
01
—
7875588-1202
CHIROPRACTIC LICENSE
UT
Enumeration date
05/16/2013
Last updated
08/03/2023
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