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General NPI Number Information
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NPI Number | 1508465626
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Entity Type | Individual
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Provider Name | CANDICE MCCOY PT, DPT, NCS
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Gender | Female
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 700 STOCKWELL RD STE 400
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City | BOSSIER CITY
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State | LA
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Zip | 71111-7027
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Country | US
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Telephone | 318-222-8892
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Fax | 318-222-8893
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Provider Business Mailing Address
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Address Line | 663 JORDAN ST
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City | SHREVEPORT
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State | LA
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Zip | 71101-4748
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Country | US
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Telephone | 318-222-8892
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Fax | 318-222-8893
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP051025T
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4446
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2020033689
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License Number State | MO
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