Individual
VICKIE CANNADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6140 WOODSIDE EXECUTIVE CT, AIKEN, SC 29803-3820
(803) 642-0700
Mailing address
6140 WOODSIDE EXECUTIVE CT, AIKEN, SC 29803-3820
(803) 642-0700
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1308
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1308
STATE LICENSE
SC
Enumeration date
10/12/2015
Last updated
10/12/2015
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