Individual
MRS. LISA RENEE CANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
20531 DARDEN RD, SOUTH BEND, IN 46637-2915
(574) 272-0100
Mailing address
55856 ROOSTER LN, OSCEOLA, IN 46561-9145
(574) 674-6015
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009265A
IN
225100000X
Physical Therapist
102570
MO
Other
Enumeration date
11/08/2011
Last updated
11/08/2011
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