Provider Demographics
NPI:1679210835
Name:LUDWIG, EVAN (DC)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:LUDWIG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1962 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-8384
Mailing Address - Country:US
Mailing Address - Phone:814-693-3730
Mailing Address - Fax:814-693-2160
Practice Address - Street 1:1962 PLANK RD
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-8384
Practice Address - Country:US
Practice Address - Phone:814-693-3730
Practice Address - Fax:814-693-2160
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor