Individual
MRS. CANDACE FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
50 SWALLOWTAIL CT, COLUMBIA, SC 29229-7199
(803) 200-3558
Mailing address
50 SWALLOWTAIL CT, COLUMBIA, SC 29229-7199
(803) 200-3558
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
105164717
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
DO NOT HAVE IDENTIFIER
—
Enumeration date
08/26/2022
Last updated
08/26/2022
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