Provider Demographics
NPI:1811871932
Name:MANDICH, MADILYN (DPT)
Entity type:Individual
Prefix:
First Name:MADILYN
Middle Name:
Last Name:MANDICH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5612 GLEN COVE CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-8661
Mailing Address - Country:US
Mailing Address - Phone:301-514-9645
Mailing Address - Fax:
Practice Address - Street 1:1664 BOWMANS FARM RD STE A
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-3190
Practice Address - Country:US
Practice Address - Phone:240-252-4597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist