Individual
MISS CANDACE MARIE RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
5255 W OVERLAND RD, BOISE, ID 83705-2637
(208) 338-9486
(208) 338-9586
Mailing address
5255 W OVERLAND RD, BOISE, ID 83705-2637
(208) 338-9486
(208) 338-9586
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2274
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT2274
STATE LICENSE
ID
Enumeration date
08/23/2007
Last updated
03/21/2013
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