Provider Demographics
NPI:1063758746
Name:LUDWIKOSKY, BETHANY (OT)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:LUDWIKOSKY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:
Other - Last Name:BECKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 ALBERT AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTT CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67871-6117
Mailing Address - Country:US
Mailing Address - Phone:620-872-5811
Mailing Address - Fax:620-872-3660
Practice Address - Street 1:201 ALBERT AVE
Practice Address - Street 2:
Practice Address - City:SCOTT CITY
Practice Address - State:KS
Practice Address - Zip Code:67871-6117
Practice Address - Country:US
Practice Address - Phone:620-872-5811
Practice Address - Fax:620-872-7193
Is Sole Proprietor?:No
Enumeration Date:2012-12-27
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02752225X00000X
KS1702752225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist