MEDICARE: MRS. PATRICIA ANN LUDWIG

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	R0815	MO

General Provider Information

NPI Number	:	1265761787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA ANN LUDWIG

Provider Business Mailing Address
First Line	:	1738 WOODMORE OAKS DR
Second Line	:
City	:	MANCHESTER
State	:	MO
Zip	:	63021-7145
Country	:	US
Telephone Number	:	636-227-8776
Fax Number	:

Provider Business Practice Location Address
First Line	:	1738 WOODMORE OAKS DR
Second Line	:
City	:	MANCHESTER
State	:	MO
Zip	:	63021-7145
Country	:	US
Telephone Number	:	636-227-8776
Fax Number	:

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

Provider Enumeration Date	:	12/11/2009
Last Update Date	:	12/11/2009

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