| Doctor Name: | MICHELLE I CANNON |
| NPI Number: | 1629418496 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT12731 |
| Business Practice Address: | 1847 Vista Lakes Dr Fleming Island, FL - 320037301 |
| Business Phone Number: | 9047038030 |
| Business Fax Number: | |
| Mailing Address: | 1847 Vista Lakes Dr, FLEMING ISLAND |
| State: | FL |
| Postal Code: | 320037301 |
| Phone Number: | 9047038030 |
| Fax Number: | |
| NPI Enumeration Date: | 06/26/2013 |
| NPI Last Update Date: | 06/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT12731 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |