Provider Demographics
NPI:1720536907
Name:LUDWIG, COLT (DC)
Entity Type:Individual
Prefix:DR
First Name:COLT
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 1:140 GAUL DR
Mailing Address - Street 2:
Mailing Address - City:SERGEANT BLUFF
Mailing Address - State:IA
Mailing Address - Zip Code:51054-8963
Mailing Address - Country:US
Mailing Address - Phone:712-943-6020
Mailing Address - Fax:712-943-6090
Practice Address - Street 1:140 GAUL DR
Practice Address - Street 2:
Practice Address - City:SERGEANT BLUFF
Practice Address - State:IA
Practice Address - Zip Code:51054-8963
Practice Address - Country:US
Practice Address - Phone:712-943-6020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA084054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor