Organization
LEAD THE PACK PHYSIOTHERAPY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN PATRICK CANNON PT, DPT (PRESIDENT)
(858) 252-8067
Entity
Organization
Contact information
Practice address
873 STEVENS AVE APT 3202, SOLANA BEACH, CA 92075-2705
(858) 252-8067
Mailing address
873 STEVENS AVE APT 3202, SOLANA BEACH, CA 92075-2705
(858) 252-8067
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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