Provider Demographics
NPI:1780232637
Name:LUDWIG, ROBERT BRIAN (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRIAN
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 1:400 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:KS
Mailing Address - Zip Code:67554-1819
Mailing Address - Country:US
Mailing Address - Phone:620-257-2040
Mailing Address - Fax:620-257-2038
Practice Address - Street 1:400 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:KS
Practice Address - Zip Code:67554-1819
Practice Address - Country:US
Practice Address - Phone:620-257-2040
Practice Address - Fax:620-257-2040
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor