Provider Demographics
NPI:1376789347
Name:COFFMAN, CANDACE ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:ELIZABETH
Last Name:COFFMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7013 BAYTON PL
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-8117
Mailing Address - Country:US
Mailing Address - Phone:440-669-9395
Mailing Address - Fax:
Practice Address - Street 1:536 S TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3418
Practice Address - Country:US
Practice Address - Phone:419-528-3150
Practice Address - Fax:419-528-3152
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 012173225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist