Provider Demographics
NPI:1447311626
Name:LUDWICK, RUTH ANNE (PT)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ANNE
Last Name:LUDWICK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:ANNE
Other - Last Name:RENKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8700 DURAND AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:STURTEVANT
Mailing Address - State:WI
Mailing Address - Zip Code:53177
Mailing Address - Country:US
Mailing Address - Phone:877-552-2996
Mailing Address - Fax:866-245-8064
Practice Address - Street 1:841 S SAGINAW RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640
Practice Address - Country:US
Practice Address - Phone:866-625-3570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010552225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist