Individual
MRS. MELISSA CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5805 STATE BRIDGE RD STE G321, DULUTH, GA 30097-8220
(770) 713-3728
Mailing address
6325 HAMPTON CREEK DR, CUMMING, GA 30041-4032
(404) 966-4009
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
001926
GA
Other
Enumeration date
04/14/2009
Last updated
04/14/2009
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