Healthcare Provider Details

I. General information

NPI: 1588731848
Provider Name (Legal Business Name): GLENN B LUDWIG PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 KILDAIRE PARK DR STE 314
CARY NC
27518-8144
US

IV. Provider business mailing address

3001 EDWARDS MILL RD STE 200
RALEIGH NC
27612-5243
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-4060
  • Fax: 919-781-5246
Mailing address:
  • Phone: 919-781-5600
  • Fax: 919-863-6821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP10863
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: