Individual
MRS. CANDICE MIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7301 HENNESSY BLVD, SUITE 101, BATON ROUGE, LA 70808-4384
(225) 767-5004
(225) 767-3117
Mailing address
10030 RIVER RUN ESTATE DR, SAINT AMANT, LA 70774-4701
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06939
LA
Other
Enumeration date
04/26/2013
Last updated
04/26/2013
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