Provider Demographics
NPI:1194559245
Name:LUDWIG, ERICA (LMT)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 WEXFORD BAYNE RD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8748
Mailing Address - Country:US
Mailing Address - Phone:563-940-5983
Mailing Address - Fax:888-299-2936
Practice Address - Street 1:141 WEXFORD BAYNE RD
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8748
Practice Address - Country:US
Practice Address - Phone:724-940-3900
Practice Address - Fax:888-299-2936
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG003073225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty