Kelly Cannon, is a
Massage Therapist based in Plainfield, New Jersey. Kelly Cannon is licensed to practice in New Jersey (license number 18KT01217200) and his current practice location is
83 Brokaw Blvd, Plainfield, New Jersey. He can be reached at his office (for appointments etc.) via phone at
(856) 383-9831.
NPI number for Kelly Cannon is 1801494844 and his current mailing address is 83 Brokaw Blvd, Plainfield, New Jersey. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1801494844.
Healthcare Provider's Profile
| Full Name | Kelly Cannon |
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| Gender | Male |
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| Speciality | Massage Therapist |
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| Location | 83 Brokaw Blvd, Plainfield, New Jersey |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1801494844
- Provider Enumeration Date: 10/13/2020
- Last Update Date: 10/13/2020
Medical Identifiers
Medical identifiers for Kelly Cannon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1801494844 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225700000X | Massage Therapist | 18KT01217200 (New Jersey) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Cannon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kelly Cannon,
83 Brokaw Blvd,
Plainfield, NJ 07063-1067
Ph: (856) 383-9831 | Kelly Cannon,
83 Brokaw Blvd,
Plainfield, NJ 07063-1067
Ph: (856) 383-9831 |
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