Organization
PA MANDICH & ASSOCIATES P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL ANDREW MANDICH D.C. (CHIROPRACTOR)
(219) 924-4456
Entity
Organization
Contact information
Practice address
2617 45TH ST, HIGHLAND, IN 46322-2902
(219) 924-4456
Mailing address
2617 45TH ST, HIGHLAND, IN 46322-2902
(219) 924-4456
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08000721A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20001330A
—
IN
01
—
90000622
BCBC OF ILLINOIS
IL
Enumeration date
03/16/2007
Last updated
11/02/2011
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