Provider Demographics
NPI:1306022611
Name:WARD CHIROPRACTIC CENTER P.L.L.C.
Entity Type:Organization
Organization Name:WARD CHIROPRACTIC CENTER P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-459-4458
Mailing Address - Street 1:7680 N CANTON CENTER RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-1500
Mailing Address - Country:US
Mailing Address - Phone:734-459-4458
Mailing Address - Fax:734-459-3870
Practice Address - Street 1:7680 N CANTON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1500
Practice Address - Country:US
Practice Address - Phone:734-459-4458
Practice Address - Fax:734-459-3870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005653111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
950Q25110OtherBLUE CROSS BLUE SHIELD
MI0Q25110Medicare PIN