Individual
CANDACE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 W BREVARD ST, UNIT 1, TALLAHASSEE, FL 32304-7839
(850) 577-0505
Mailing address
924 SAINT PATRICK DR, TALLAHASSEE, FL 32310-1115
(850) 727-9482
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CL1209093
FL
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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