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General NPI Number Information
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NPI Number | 1235510744
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Entity Type | Individual
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Provider Name | EMMA OCTAVIA LADWIG
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Gender | Female
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 440 E CHERRY ST
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City | VERMILLION
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State | SD
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Zip | 57069-1403
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Country | US
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Telephone | 605-741-0003
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Fax |
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Provider Business Mailing Address
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Address Line | 2122 YORK RD STE 300
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City | OAK BROOK
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State | IL
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Zip | 60523-1925
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3452
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1825
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License Number State | SD
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