Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 9474 | AZ |
NPI | 1003195660 |
---|---|
Provider Name | Candice Anne Hill |
First Address | Mesa, AZ 85204-4029 |
Second Address | Scottsdale, AZ 85257-3919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2011 |
Last Update Date | 12/08/2011 |