Provider Demographics
NPI:1033541453
Name:WARD, BRUCE MICHAEL JR (DC)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:MICHAEL
Last Name:WARD
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1909 N HIGHWAY 17
Mailing Address - Street 2:SUITE I
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7459
Mailing Address - Country:US
Mailing Address - Phone:843-971-0540
Mailing Address - Fax:843-971-0340
Practice Address - Street 1:1909 N HIGHWAY 17
Practice Address - Street 2:SUITE I
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7459
Practice Address - Country:US
Practice Address - Phone:843-971-0540
Practice Address - Fax:843-971-0340
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3842111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor