Provider Demographics
NPI:1588915474
Name:LUDWIG, HEATHER ELAINE (MPT)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ELAINE
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 TROY SQ
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-3108
Mailing Address - Country:US
Mailing Address - Phone:636-528-7333
Mailing Address - Fax:
Practice Address - Street 1:55 TROY SQ
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MO
Practice Address - Zip Code:63379-3108
Practice Address - Country:US
Practice Address - Phone:636-528-7333
Practice Address - Fax:636-528-7333
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008000533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist