Individual
MR. TIMOTHY S BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
411 E FRANKLIN BLVD, GASTONIA, NC 28054-7152
(704) 864-7774
(704) 810-8998
Mailing address
411 E FRANKLIN BLVD, GASTONIA, NC 28054-7152
(704) 864-7774
(704) 810-8998
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
200001321211
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890842V
—
NC
Enumeration date
08/30/2006
Last updated
01/28/2015
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