Provider Demographics
NPI:1821470709
Name:LINDEMAN, MATTHEW J (DPT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:LINDEMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:611 HIGHWAY 74 S
Practice Address - Street 2:SUITE 720
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3081
Practice Address - Country:US
Practice Address - Phone:770-632-6800
Practice Address - Fax:770-632-6060
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist