Individual
MS. MARY MUNDRANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT,ATC,CHT
Contact information
Practice address
230 BEISER BLVD, SUITE 103, DOVER, DE 19904-7793
(302) 736-0994
(302) 736-5529
Mailing address
230 BEISER BLVD, SUITE 103, DOVER, DE 19904-7793
(302) 736-0994
(302) 736-5529
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
J10000814
DE
2251G0304X
Geriatric Physical Therapist
J10000814
DE
2251H1200X
Hand Physical Therapist
Primary
J10000814
DE
2251S0007X
Sports Physical Therapist
J10000814
DE
2251X0800X
Orthopedic Physical Therapist
J10000814
DE
2255A2300X
Athletic Trainer
J3-0000050
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0717329000
AMERIHEALTH
DE
01
—
P00294512
MEDICARE RAILROAD
DE
Enumeration date
04/12/2006
Last updated
02/01/2008
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