Provider Demographics
NPI:1225222847
Name:HUDACK, LINDSEY E (PT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:E
Last Name:HUDACK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:E
Other - Last Name:WSZALEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:909 S WASHBURN ST
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-8051
Mailing Address - Country:US
Mailing Address - Phone:920-235-8966
Mailing Address - Fax:920-235-1526
Practice Address - Street 1:909 S WASHBURN ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-8051
Practice Address - Country:US
Practice Address - Phone:920-235-8966
Practice Address - Fax:920-235-1526
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10886-024225100000X
WI10866-0242251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic