Individual ProviderBrianna C LudtkePhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address8290 University Ave NE Ste 200, Fridley, MN 55432(763) 786-9543PECOS EnrollmentBased on the most recent information from CMS, provider Brianna C Ludtke does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1275900391Provider TypeIndividualFull NameLudtke, Brianna CCredentialPT, DPTGenderFemaleSole ProprietorNoEnumeration Date8/24/2015Last Updated7/30/2018Contact InformationPractice LocationPractice Address8290 University Ave NE Ste 200, Fridley, MN 55432Phone(763) 786-9543Fax(763) 786-3320Mailing LocationMailing Address8290 University Ave NE Ste 200, Fridley, MN 55432-1876Phone(763) 786-9543Fax(763) 786-3320Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense10029Minnesota