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NPI Code Detail

MEDICARE: ANGEE LUDWA PT

MEDICARE: ANGEE LUDWA PT
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 Therapist5501009064MI

General Provider Information

NPI Number : 1457718330
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGEE LUDWA PT
Provider Business Mailing Address
First Line : 3495 S CENTER RD
Second Line :
City : BURTON
State : MI
Zip : 48519-1455
Country : US
Telephone Number : 810-424-2011
Fax Number : 810-249-4037
Provider Business Practice Location Address
First Line : 8447 HOLLY RD
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-1888
Country : US
Telephone Number : 888-216-4045
Fax Number : 810-249-4230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2016
Last Update Date : 01/22/2016

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Directions to “ ANGEE LUDWA PT” Practice Location

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