Provider Demographics
NPI:1447418033
Name:LUDWELL CHIROPRACTIC & SPORTS REHAB INC
Entity Type:Organization
Organization Name:LUDWELL CHIROPRACTIC & SPORTS REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:LUDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-224-4400
Mailing Address - Street 1:419 FIELDCREST
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73018
Mailing Address - Country:US
Mailing Address - Phone:405-224-4400
Mailing Address - Fax:
Practice Address - Street 1:419 FIELDCREST
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018
Practice Address - Country:US
Practice Address - Phone:405-224-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKW89000001Medicare PIN