MEDICARE: DEIDRE C VERLINDEN PT

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	070021723	IL

General Provider Information

NPI Number	:	1255707691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEIDRE C VERLINDEN PT

Provider Business Mailing Address
First Line	:	163 THOMAS JOHNSON DR
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-4673
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	163 THOMAS JOHNSON DR
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-4673
Country	:	US
Telephone Number	:	240-566-3132
Fax Number	:

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

Provider Enumeration Date	:	08/20/2015
Last Update Date	:	09/26/2022

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Directions to “ DEIDRE C VERLINDEN PT” Practice Location

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