Provider Demographics
NPI:1427849553
Name:PRIKLER, LUDOVIT REUBEN (LMT)
Entity type:Individual
Prefix:
First Name:LUDOVIT
Middle Name:REUBEN
Last Name:PRIKLER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4163
Mailing Address - Street 2:
Mailing Address - City:BISBEE
Mailing Address - State:AZ
Mailing Address - Zip Code:85603-4163
Mailing Address - Country:US
Mailing Address - Phone:520-559-1330
Mailing Address - Fax:
Practice Address - Street 1:103 TURQUOISE ST
Practice Address - Street 2:
Practice Address - City:BISBEE
Practice Address - State:AZ
Practice Address - Zip Code:85603-9782
Practice Address - Country:US
Practice Address - Phone:520-559-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-28731225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist