Doctor Name: | MR. RANDY T CANNON |
NPI Number: | 1295803799 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | PT0000001415 |
Business Practice Address: | 785 Us Hwy 321 N Ste 20 Lenoir City, TN - 37771 |
Business Phone Number: | 8659866611 |
Business Fax Number: | 8659886904 |
Mailing Address: | Po Box 6167, MARYVILLE |
State: | TN |
Postal Code: | 378026167 |
Phone Number: | 8659778007 |
Fax Number: | 8659774072 |
NPI Enumeration Date: | 12/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT0000001415 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |