Individual
MR. CHARLES CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1953 CRANE CREEK BLVD, MELBOURNE, FL 32940-6832
(214) 564-8293
Mailing address
1953 CRANE CREEK BLVD, MELBOURNE, FL 32940-6832
(214) 564-8293
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA24789
FL
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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