Healthcare Provider Details

I. General information

NPI: 1063800902
Provider Name (Legal Business Name): RYAN MICHAEL LUDWIG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2014
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 MAIN ST STE 110
BUFFALO NY
14209-1911
US

IV. Provider business mailing address

PO BOX 604
EAST AURORA NY
14052-0604
US

V. Phone/Fax

Practice location:
  • Phone: 716-200-0651
  • Fax: 716-939-3867
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX012610
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: