Provider Information for 1073901401
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HEATHER ALLISON LUDWIG
Sex: Female
NPI: 1073901401
Last Updated: 2019-01-03
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1073901401 | ||||||||
| Enumeration Date | 2015-01-08 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1901 S JONES BLVD LAS VEGAS, NV 89146-1260 United States Phone: 701-815-1550 | Fax: | ||||||||
| Primary Practice Address | 1901 S JONES BLVD LAS VEGAS, NV 89146-1260 United States Phone: 701-815-1550 | Fax: | ||||||||
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