Individual
JACKIE B CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
35111 SEAGRASS PLANTATION LN, DAGSBORO, DE 19939
(866) 484-8193
(888) 516-4393
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
Primary
PT003408L
PA
2251X0800X
Orthopedic Physical Therapist
6994
SC
Other
Enumeration date
02/21/2007
Last updated
02/25/2019
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