Individual
ALLIE MARIE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4403 HARRISON BLVD STE 4410, OGDEN, UT 84403-3323
(801) 387-2750
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14198438-1206
UT
Other
Enumeration date
02/14/2025
Last updated
12/02/2025
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