Stephen Cannon
Individual provider Active NPI Physical Therapist · Leicester, MA
NPI 1396067971 · NPPES record last updated Feb 23, 2010
Key facts
- NPI
- 1396067971
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5293 (MA)
- Practice address
- 1037 Main St
Leicester, MA 01524-1313 - Phone
- (508) 892-1335
- Fax
- (508) 892-1780
- NPI assigned
- Feb 23, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5293 | MA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5293 | MA | Yes |
Addresses
Primary practice location
1037 Main St
Leicester, MA 01524-1313
Mailing address
1037 Main St
Leicester, MA 01524-1313
Phone (508) 892-1335
Other providers in Leicester, MA
- Carol Ann Berglund
- Kendra Marie Beveridge
- Caitlin Marie Bonneville
- Dana Booth
- James Buzzell
- Caring Hands Home Care LLC
- Central Mass Sleep Solutions LLC
- Jeanne Elizabeth Chaclas
- Chiropractic Business Associates Inc.
- Comprehensive Physical Therapy, PC
All providers in Leicester, MA · Physical Therapist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.