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Individual

DR. PAUL A MANDICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2617-45TH STREET, HIGHLAND, IN 46322-2902
(219) 924-4456
(219) 924-6342
Mailing address
2617-45TH STREET, HIGHLAND, IN 46322-2902
(219) 924-4456
(219) 924-6342

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08000721A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000090592
ANTHEM BC/BS
IN
01
90000622
BCBS OF ILLINOIS
IL
Enumeration date
07/13/2006
Last updated
07/08/2007
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