Provider Demographics
NPI:1245381359
Name:LUDWIG-COHEN, RITA ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:ANN
Last Name:LUDWIG-COHEN
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 1:1226 N HIGHWAY 99W
Mailing Address - Street 2:PO BOX 86
Mailing Address - City:DUNDEE
Mailing Address - State:OR
Mailing Address - Zip Code:97115-9748
Mailing Address - Country:US
Mailing Address - Phone:503-538-9119
Mailing Address - Fax:503-538-9119
Practice Address - Street 1:1226 N HIGHWAY 99W # 86
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:OR
Practice Address - Zip Code:97115-9748
Practice Address - Country:US
Practice Address - Phone:503-538-9119
Practice Address - Fax:503-538-9119
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 1333111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0000QGBKTMedicare ID - Type Unspecified