Healthcare Provider Details
I. General information
NPI: 1851569180
Provider Name (Legal Business Name): LUDWIG CHIROPRACTIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2008
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1408 LAKE TAPPS PKWY E SUITE E105
AUBURN WA
98092-8158
US
IV. Provider business mailing address
1408 LAKE TAPPS PKWY E SUITE E105
AUBURN WA
98092-8158
US
V. Phone/Fax
- Phone: 253-735-0123
- Fax: 253-735-0759
- Phone: 253-735-0123
- Fax: 253-735-0759
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | CH00001452 |
| License Number State | WA |
VIII. Authorized Official
Name: DR.
ALAN
STEVEN
LUDWIG
Title or Position: OWNER/DIRECTOR
Credential: D.C.
Phone: 253-735-0123