1093966848 NPI number — WARD CHIROPRACTIC & REHABILITATION CENTER, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093966848 NPI number — WARD CHIROPRACTIC & REHABILITATION CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WARD CHIROPRACTIC & REHABILITATION CENTER, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093966848
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2100 BAYNARD BLVD
Provider Second Line Business Mailing Address:
LOWER LEVEL
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19802-3900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-225-9000
Provider Business Mailing Address Fax Number:
302-225-9005

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2100 BAYNARD BLVD
Provider Second Line Business Practice Location Address:
LOWER LEVEL
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19802-3900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-225-9000
Provider Business Practice Location Address Fax Number:
302-225-9005
Provider Enumeration Date:
10/09/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WARD
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
WINFIELD
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
302-225-9000

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  F10000477 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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