Provider Demographics
NPI:1003195660
Name:HILL, CANDICE ANNE (PT)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:ANNE
Last Name:HILL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:ANNE
Other - Last Name:COLTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3445 E DRAGOON AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-4029
Mailing Address - Country:US
Mailing Address - Phone:801-884-8233
Mailing Address - Fax:
Practice Address - Street 1:1475 N GRANITE REEF RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-3919
Practice Address - Country:US
Practice Address - Phone:480-990-1904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9474225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist