Individual
MRS. BEVERLY WOLF LUEDKE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
701 MURRAY AVE, ROCKDALE, TX 76567-2763
(512) 446-9990
(512) 446-9991
Mailing address
PO BOX 637, ROSEBUD, TX 76570-0637
(254) 583-4690
(254) 583-2038
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1019172
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019172
STATE PROFESSIONAL LICENS
TX
Enumeration date
05/30/2006
Last updated
07/09/2007
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