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Individual

CANNON LEIGH HANEBUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT,DPT

Contact information

Practice address
21 LOWER RAGSDALE DR, MONTEREY, CA 93940-5827
(831) 264-6040
Mailing address
877 TYLERTON CIR, GRAYSLAKE, IL 60030-7901
(847) 650-0978

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305214431
CA
225100000X
Physical Therapist
Primary
301734
CA

Other

Enumeration date
12/22/2021
Last updated
04/07/2022
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