Provider Demographics
NPI:1245840206
Name:LADD, MARY (DPT)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:LADD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 69TH ST
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-3820
Mailing Address - Country:US
Mailing Address - Phone:630-776-8911
Mailing Address - Fax:
Practice Address - Street 1:4101 W HARDY RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-8917
Practice Address - Country:US
Practice Address - Phone:520-579-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist