Provider Demographics
NPI:1558468363
Name:HODNETT, CANDY E (PT)
Entity Type:Individual
Prefix:MS
First Name:CANDY
Middle Name:E
Last Name:HODNETT
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 1:8049 HIGGINS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14735-8691
Mailing Address - Country:US
Mailing Address - Phone:585-567-4548
Mailing Address - Fax:585-567-4548
Practice Address - Street 1:8049 HIGGINS CREEK RD
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:NY
Practice Address - Zip Code:14735-8691
Practice Address - Country:US
Practice Address - Phone:585-567-4548
Practice Address - Fax:585-567-4548
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017822-1225100000X
NY017866-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist