Individual
MARCUS LARAY CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 E 55TH ST, CLEVELAND, OH 44103-1304
(216) 391-6672
Mailing address
10614 CRESTWOOD AVE, CLEVELAND, OH 44104-3511
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/20/2020
Last updated
04/20/2020
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