Individual
DR. PHILLIP RANDAL CANNON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 461-5257
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 461-5257
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-4948
HI
Other
Enumeration date
08/14/2019
Last updated
04/30/2025
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