Individual
MARC ANTHONY CANNELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
108 DEBO DR STE 130, MYRTLE BEACH, SC 29579-4918
(843) 796-2850
Mailing address
108 DEBO DR STE 130, MYRTLE BEACH, SC 29579-4918
(843) 796-2850
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11896
SC
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
10/25/2017
Last updated
07/21/2023
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