Individual
MR. JACOB HARRISON CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHT
Contact information
Practice address
194 JACOBS HWY, CLINTON, SC 29325-7276
(864) 833-5000
Mailing address
332 BEULAH LN, IRMO, SC 29063-9573
(803) 447-9688
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
58380
SC
Other
Enumeration date
10/06/2022
Last updated
10/17/2022
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