DERRICK CANNON

FAIRBANKS, AK
NPI1598192312
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: AK  PHYP2677)
Enumeration Date2013-10-11
Last Update Date2017-02-15
Business Address
DERRICK CANNON PT, DPT
398 HAMILTON AVE
FAIRBANKS, AK 99701-3537
Phone number: 907-374-4911
Mailing Address
DERRICK CANNON PT, DPT
398 HAMILTON AVE
FAIRBANKS, AK 99701-3537
Phone number: 907-374-4911
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