Provider Demographics
NPI:1730241837
Name:LUDWIG, BRYAN FRANCIS (DC)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:FRANCIS
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 1:109 PARK PL STE 2
Mailing Address - Street 2:
Mailing Address - City:COBLESKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12043-4634
Mailing Address - Country:US
Mailing Address - Phone:518-234-1512
Mailing Address - Fax:
Practice Address - Street 1:109 PARK PL STE 2
Practice Address - Street 2:
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-4634
Practice Address - Country:US
Practice Address - Phone:518-234-1512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008098-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC08089-8WOtherWORKERS COMPENSATION
NYC08089-8WOtherWORKERS COMPENSATION
NY55924BMedicare ID - Type Unspecified