Provider Demographics
NPI:1417596172
Name:EHLERS, GREG (EDD, LAT)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:
Last Name:EHLERS
Suffix:
Gender:M
Credentials:EDD, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W51N215 FILLMORE AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-2939
Mailing Address - Country:US
Mailing Address - Phone:414-690-0874
Mailing Address - Fax:
Practice Address - Street 1:W51N215 FILLMORE AVE
Practice Address - Street 2:
Practice Address - City:CEDARBURG
Practice Address - State:WI
Practice Address - Zip Code:53012-2939
Practice Address - Country:US
Practice Address - Phone:414-690-0874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-29
Last Update Date:2019-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer