Provider Demographics
NPI:1467531244
Name:HUTCHISON, CANDY (PT)
Entity Type:Individual
Prefix:
First Name:CANDY
Middle Name:
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 TURTLE HOLW
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-5058
Mailing Address - Country:US
Mailing Address - Phone:601-622-7989
Mailing Address - Fax:
Practice Address - Street 1:308 TURTLE HOLW
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-5058
Practice Address - Country:US
Practice Address - Phone:601-665-3001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2020-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT 3785225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS25-4533Medicare ID - Type Unspecified