Individual
JEREMY CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
95 SEA ISLAND PKWY STE 103, BEAUFORT, SC 29907-1499
(803) 942-6412
Mailing address
95 SEA ISLAND PKWY STE 103, BEAUFORT, SC 29907-1499
(843) 379-3991
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3416
SC
Other
Enumeration date
03/03/2016
Last updated
06/11/2022
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