Provider Demographics
NPI:1548637978
Name:RUMMEL, CANDACE
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:RUMMEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 SIEMON DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-7055
Mailing Address - Country:US
Mailing Address - Phone:814-443-2811
Mailing Address - Fax:814-445-3210
Practice Address - Street 1:228 SIEMON DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-7055
Practice Address - Country:US
Practice Address - Phone:814-443-2811
Practice Address - Fax:814-445-3210
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT014107L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist