Organization
FIT CONSULTANTS PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKIE B CANNON PT, DPT, MBA, ATC, (OWNER, PRESIDENT)
(866) 484-8183
Entity
Organization
Contact information
Practice address
35111 SEAGRASS PLANTATION LN, DAGSBORO, DE 19939
(866) 484-8193
Mailing address
35111 SEAGRASS PLANTATION LN, DAGSBORO, DE 19939-3391
(866) 484-8193
(888) 516-4393
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
PT003408L
PA
261QP2000X
Physical Therapy Clinic/Center
Primary
PT003408L
PA
Other
Enumeration date
06/05/2011
Last updated
03/04/2019
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