Provider Demographics
NPI:1376929869
Name:MADANY, JOHANNA HELMINA (DPT)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:HELMINA
Last Name:MADANY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2722 TORINO REALE AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-7995
Mailing Address - Country:US
Mailing Address - Phone:425-223-2512
Mailing Address - Fax:
Practice Address - Street 1:2170 N MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1919
Practice Address - Country:US
Practice Address - Phone:254-773-6787
Practice Address - Fax:254-770-0516
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60564368225100000X, 2251P0200X
TX13566902251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist