Individual
JEB KINCANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
6500 CRILL AVE BLDG 3, PALATKA, FL 32177-9231
(386) 325-1119
Mailing address
PO BOX 1473, ST AUGUSTINE, FL 32085-1473
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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