Provider Demographics
NPI:1023893278
Name:HUNT, KANDICE (DPT)
Entity type:Individual
Prefix:
First Name:KANDICE
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KANDICE
Other - Middle Name:
Other - Last Name:GAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 HYLINE DR
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76031-7807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:109 HYLINE DR
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76031-7807
Practice Address - Country:US
Practice Address - Phone:541-921-5189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1383006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist