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Individual
KEVIN CHARLES CANNON
Active
Individual
KEVIN CHARLES CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11285279-2401
UT
2251C2600X
Cardiopulmonary Physical Therapist
Primary
1572324
WI
Other
Enumeration date
10/01/2020
Last updated
07/23/2025
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