Individual
BRANDON SCOTT LADWIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3810 N 173RD AVE, OMAHA, NE 68116-3124
(402) 740-2484
Mailing address
3810 N 173RD AVE, OMAHA, NE 68116-3124
(402) 740-2484
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
087090
IA
225200000X
Physical Therapy Assistant
Primary
1554
NE
225200000X
Physical Therapy Assistant
A-1398
NM
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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