Individual
MS. CANDICE RHEA BREEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5146 STAGE RD, SUITE 102, MEMPHIS, TN 38134-3164
(901) 380-2727
(901) 380-2722
Mailing address
5146 STAGE RD, SUITE 102, MEMPHIS, TN 38134-3164
(901) 380-2727
(901) 380-2722
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA0000003613
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183838
BLUE CROSS PROVIDER
TN
Enumeration date
11/29/2006
Last updated
07/08/2007
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