Organization
I CANDY THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAQUAN EMMANUEL FERGERSON (OWNER)
(929) 363-4533
Entity
Organization
Contact information
Practice address
16012 S WESTERN AVE STE 101, GARDENA, CA 90247-3797
(626) 604-2159
Mailing address
16012 S WESTERN AVE STE 101, GARDENA, CA 90247-3797
(626) 604-2159
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M1
M1
CA
Enumeration date
12/12/2022
Last updated
12/12/2022
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