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Individual

DALE ALLEN LUDKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ORTHOTIC FITTER

Contact information

Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Mailing address
15741 N 162ND LN, SURPRISE, AZ 85374-5875
(602) 277-5551

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
10/06/2008
Last updated
10/06/2008
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