Individual
CASSANDRA CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5423 KILLENS POND RD, FELTON, DE 19943-1901
(302) 284-5810
Mailing address
5424 KILLENS POND RD, FELTON, DE 19943-1902
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
J20000994
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J2-0000994
STATE OF DELAWARE
DE
Enumeration date
09/05/2017
Last updated
09/05/2017
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