Provider Demographics
NPI:1629283601
Name:HLADIUK, ERIN L (PT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:L
Last Name:HLADIUK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1762 DUMONT DR
Mailing Address - Street 2:
Mailing Address - City:MINERAL RIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:44440-9508
Mailing Address - Country:US
Mailing Address - Phone:330-544-1072
Mailing Address - Fax:
Practice Address - Street 1:1762 DUMONT DR
Practice Address - Street 2:
Practice Address - City:MINERAL RIDGE
Practice Address - State:OH
Practice Address - Zip Code:44440-9508
Practice Address - Country:US
Practice Address - Phone:330-544-1072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9718225100000X
WA10373225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist