Provider Demographics
NPI:1083945703
Name:LUDVIGSON, KAYLA M (DC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:M
Last Name:LUDVIGSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 N 2ND ST STE A
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:IA
Mailing Address - Zip Code:51012-1859
Mailing Address - Country:US
Mailing Address - Phone:712-225-6198
Mailing Address - Fax:712-225-6228
Practice Address - Street 1:213 N 2ND ST STE A
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:IA
Practice Address - Zip Code:51012-1859
Practice Address - Country:US
Practice Address - Phone:712-225-6198
Practice Address - Fax:712-225-6228
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007269111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor