Individual
MR. RANDY T CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
785 US HWY 321 N, STE 20, LENOIR CITY, TN 37771
(865) 986-6611
(865) 988-6904
Mailing address
PO BOX 6167, MARYVILLE, TN 37802-6167
(865) 977-8007
(865) 977-4072
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000001415
TN
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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