Provider Demographics
NPI:1811181548
Name:LUDWIG, KASI LEE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KASI
Middle Name:LEE
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N1788 LILY OF THE VALLEY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54942-9103
Mailing Address - Country:US
Mailing Address - Phone:920-757-3096
Mailing Address - Fax:920-757-3099
Practice Address - Street 1:N1788 LILY OF THE VALLEY DR
Practice Address - Street 2:SUITE A
Practice Address - City:GREENVILLE
Practice Address - State:WI
Practice Address - Zip Code:54942-9103
Practice Address - Country:US
Practice Address - Phone:920-757-3096
Practice Address - Fax:920-757-3099
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist