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Individual
MR. MICHAEL G CANTRELL
Active
Individual
MR. MICHAEL G CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT002850
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000823963A
—
GA
01
—
5290632
BCBS
GA
Enumeration date
07/05/2006
Last updated
10/14/2011
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