Individual
RICKIE C CANNON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
4455 BARCELONA LN, LITTLE RIVER, SC 29566-8264
(828) 729-2085
Mailing address
4455 BARCELONA LN, LITTLE RIVER, SC 29566-8264
(828) 729-2085
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5165
SC
Other
Enumeration date
04/08/2026
Last updated
04/08/2026
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