Healthcare Provider Details

I. General information

NPI: 1760305437
Provider Name (Legal Business Name): CAMERON CANEDY PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8726 US-42
FLORENCE KY
41042
US

IV. Provider business mailing address

1130 TAMARACK CIR APT D
FLORENCE KY
41042-9236
US

V. Phone/Fax

Practice location:
  • Phone: 859-301-2663
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: