Provider Demographics
NPI:1245762145
Name:LUDWIG, BRITTANY ANN (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANN
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 SUNDANCE CIR NW
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-9075
Mailing Address - Country:US
Mailing Address - Phone:320-760-9331
Mailing Address - Fax:
Practice Address - Street 1:30 FOREST AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:MN
Practice Address - Zip Code:56307-9503
Practice Address - Country:US
Practice Address - Phone:320-760-9331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNW263237756811390200000X
MN32292255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program