MEDICARE: ANDREA KOLODGIE DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1184238628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA KOLODGIE DPT

Provider Business Mailing Address
First Line	:	1050 INDUSTRIAL DR STE 210
Second Line	:
City	:	MIDDLETOWN
State	:	DE
Zip	:	19709-2803
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1303 VEALE RD
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19810-1670
Country	:	US
Telephone Number	:	302-477-0800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2020
Last Update Date	:	05/08/2023

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Directions to “ ANDREA KOLODGIE DPT” Practice Location

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