Provider Demographics
NPI:1366818759
Name:CHAPMAN, CANDACE
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 LAKE ST.
Mailing Address - Street 2:
Mailing Address - City:PARKIN
Mailing Address - State:AR
Mailing Address - Zip Code:72373
Mailing Address - Country:US
Mailing Address - Phone:870-630-2328
Mailing Address - Fax:
Practice Address - Street 1:206 LAKE ST.
Practice Address - Street 2:
Practice Address - City:PARKIN
Practice Address - State:AR
Practice Address - Zip Code:72373
Practice Address - Country:US
Practice Address - Phone:870-630-2328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT4008225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist