MEDICARE: DR. STEPHEN CANNER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1419	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609870500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN CANNER DC

Provider Business Mailing Address
First Line	:	PO BOX 1990
Second Line	:
City	:	MARS HILL
State	:	NC
Zip	:	28754-1990
Country	:	US
Telephone Number	:	828-689-3777
Fax Number	:	828-689-5435

Provider Business Practice Location Address
First Line	:	342 CARL ELLER RD
Second Line	:
City	:	MARS HILL
State	:	NC
Zip	:	28754-6000
Country	:	US
Telephone Number	:	828-689-3777
Fax Number	:	828-689-5435

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	01/22/2010

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Directions to “ DR. STEPHEN CANNER DC” Practice Location

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