Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Derrick Cannon, PT, DPT

Individual provider Physical Therapist · NPI 1598192312

Derrick Cannon, PT, DPT is a Physical Therapist in Detroit, Michigan. Practices as a sole proprietor. Licensed in Alaska and Michigan.

Licensed in
AK, MI
In the registry since
2013
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

79 W Alexandrine St
Detroit, MI 48201-2015
Phone: (313) 831-5535
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501019771 (MI)
Physical Therapist Taxonomy 225100000X · Licence PHYP2677 (AK)

Record details

NPI number1598192312
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorYes
NPI enumeratedOctober 11, 2013
Last updated in NPPESFebruary 19, 2025
Certification dateFebruary 19, 2025
Mailing address41834 Savage Rd, Van Buren Twp, MI 48111-3095

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