Individual
CANDACE CASEY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
260 HICKORY CIRCLE, MOUNTAIN VIEW, AR 72560
(870) 615-9074
Mailing address
PO BOX 2542, MOUNTAIN VIEW, AR 72560-2542
(870) 615-9074
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-2161
AR
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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