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Search › Idaho › 208800000X

Peter Cannon, M.D

NPI 1326032939 · on the registry since 2005 · sole proprietor

Practice

Address
2001 S Woodruff Ave
Suite 4
Idaho Falls, ID 83404
Phone
(208) 524-4511
Fax
(208) 524-4540
Organisation at this address
Club, Inc.
Ascend Llc
Michele Osmond
Suzanne Godfrey
Neurofeedback Center
Inferred from a shared address, not stated in the registry.
Clinicians at this address
48

Registry record

Primary taxonomy
208800000X
208800000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2011-04-06

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho