Provider Demographics
NPI:1114026689
Name:LUDWIG, MARIANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:
Last Name:LUDWIG
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 1:12211 W BELL RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-9521
Mailing Address - Country:US
Mailing Address - Phone:623-974-3174
Mailing Address - Fax:623-974-3905
Practice Address - Street 1:12211 W BELL RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9521
Practice Address - Country:US
Practice Address - Phone:623-974-3174
Practice Address - Fax:623-974-3905
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5251111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor