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Individual

CANDICE CHESSUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1109 W MYRTLE ST, BOISE, ID 83702-6970
(208) 489-4331
Mailing address
323 W VILLAGE LN, BOISE, ID 83702-6225
(818) 590-1559

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT-4201
ID

Other

Enumeration date
09/04/2015
Last updated
09/04/2015
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