Provider Demographics
NPI:1265705818
Name:CANNON, THOMAS DAVID (MA)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:DAVID
Last Name:CANNON
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Gender:M
Credentials:MA
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Mailing Address - Street 1:1740 CLEVELAND RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2204
Mailing Address - Country:US
Mailing Address - Phone:330-287-4500
Mailing Address - Fax:330-287-4581
Practice Address - Street 1:721 E MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-1255
Practice Address - Country:US
Practice Address - Phone:330-287-4580
Practice Address - Fax:330-287-4581
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist