| Cannon Therapeutic | |
|
125 W Main St Unit 324 Midway UT 84049-8014 | |
| (949) 244-9982 | |
| Not Available |
| Full Name | Cannon Therapeutic |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 125 W Main St Unit 324, Midway, Utah |
| Authorized Official Name and Position | Tucker Croxall Cannon (OWNER, PROVIDER) |
| Authorized Official Contact | 9492449982 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cannon Therapeutic 125 W Main St Unit 324 Midway UT 84049-8014 Ph: (949) 244-9982 | Cannon Therapeutic 125 W Main St Unit 324 Midway UT 84049-8014 Ph: (949) 244-9982 |
| NPI Number | 1497624951 |
|---|---|
| Provider Enumeration Date | 11/03/2025 |
| Last Update Date | 11/03/2025 |
| Certification Date | 11/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497624951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Acqua Medical Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 N Johnson Mill Rd, Midway, UT 84049 Phone: 844-654-3700 Fax: 801-926-1133 |