Individual
HAILEY LYNN CANNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4650 SR-16, ST. AUGUSTINE, FL 32092
(904) 940-2193
Mailing address
4825 AVENUE A, ST AUGUSTINE, FL 32095-6267
(239) 331-6899
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
32688
FL
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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