Individual
JACOB CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
406 MARVEL CT, EASTON, MD 21601-4052
(410) 822-4613
(410) 822-6534
Mailing address
406 MARVEL CT, EASTON, MD 21601-4052
(410) 822-4613
(410) 822-6534
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
28475
MD
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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