Provider Demographics
NPI:1407535057
Name:CANDIDE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:CANDIDE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:AREM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:912-207-0242
Mailing Address - Street 1:9009 WAYCROSS HWY
Mailing Address - Street 2:
Mailing Address - City:SCREVEN
Mailing Address - State:GA
Mailing Address - Zip Code:31560-9271
Mailing Address - Country:US
Mailing Address - Phone:912-207-0242
Mailing Address - Fax:912-715-3822
Practice Address - Street 1:330 PEACHTREE ST
Practice Address - Street 2:
Practice Address - City:JESUP
Practice Address - State:GA
Practice Address - Zip Code:31545-0246
Practice Address - Country:US
Practice Address - Phone:912-207-0242
Practice Address - Fax:912-715-3822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty