Provider Demographics
NPI:1457341364
Name:LUDWIG, JANINE MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:MARIE
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:JANINE
Other - Middle Name:MARIE
Other - Last Name:PAWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:700 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-2126
Mailing Address - Country:US
Mailing Address - Phone:330-722-3781
Mailing Address - Fax:330-725-6294
Practice Address - Street 1:700 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-2126
Practice Address - Country:US
Practice Address - Phone:330-722-3781
Practice Address - Fax:330-725-6294
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT10866225100000X
OH10866225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2511535Medicaid
4138681Medicare PIN