Individual
CHARLEASE DEANN CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 S DUPREE AVE, BROWNSVILLE, TN 38012-3234
(731) 772-6283
Mailing address
1209 DANCYVILLE RD, STANTON, TN 38069-4664
(901) 491-2879
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000043516
TN
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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