Individual
MR. RANDALL CLAY CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
(478) 832-6506
Mailing address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
(478) 254-5463
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT011885
GA
Other
Enumeration date
06/30/2016
Last updated
03/25/2026
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