Individual
MR. JAMES DANIEL CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7801 GARNERS FERRY RD, COLUMBIA, SC 29209-3958
(803) 647-7638
(803) 647-0637
Mailing address
108 WINTERGREEN CT, LEXINGTON, SC 29072-9646
(803) 240-5719
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
I-47105
SC
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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