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NPI Code Detail

MEDICARE: DR. MARY LADD DPT

MEDICARE:  DR. MARY  LADD  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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1245840206
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY LADD DPT
Provider Business Mailing Address
First Line : 529 69TH ST
Second Line :
City : DARIEN
State : IL
Zip : 60561-3820
Country : US
Telephone Number : 630-776-8911
Fax Number :
Provider Business Practice Location Address
First Line : 4101 W HARDY RD
Second Line :
City : TUCSON
State : AZ
Zip : 85742-8917
Country : US
Telephone Number : 520-579-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2020
Last Update Date : 08/12/2021

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Directions to “ DR. MARY LADD DPT” Practice Location

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