Individual
MICHAEL KOLLIN CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5107 BEATLINE RD STE 300, LONG BEACH, MS 39560-3874
(228) 575-8429
(228) 575-8891
Mailing address
251 JOHNSTON ST SE STE 200, DECATUR, AL 35601-2515
(256) 350-1764
(256) 355-0884
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6701
MS
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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