Provider Demographics
NPI:1851569180
Name:LUDWIG CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:LUDWIG CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:LUDWIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-735-0123
Mailing Address - Street 1:1408 LAKE TAPPS PKWY E
Mailing Address - Street 2:SUITE E105
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-8158
Mailing Address - Country:US
Mailing Address - Phone:253-735-0123
Mailing Address - Fax:253-735-0759
Practice Address - Street 1:1408 LAKE TAPPS PKWY E
Practice Address - Street 2:SUITE E105
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-8158
Practice Address - Country:US
Practice Address - Phone:253-735-0123
Practice Address - Fax:253-735-0759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA56527OtherDEPARTMENT OF LABOR & IND
WAT02746Medicare UPIN