Individual
DR. LACE ELLY LUEDKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT PHD DPT OCS CSCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2611
AR
225100000X
Physical Therapist
Primary
5847024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1305
MCKENZIE INSTITUTE CERT
—
01
—
977732
NSCA CSCS
—
Enumeration date
05/03/2006
Last updated
07/21/2022
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