Provider Demographics
NPI:1467774919
Name:WARD CHIROPRACTIC & REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:WARD CHIROPRACTIC & REHABILITATION CENTER, LLC
Other - Org Name:OPTIMUM HEALTH GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:W
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-225-9000
Mailing Address - Street 1:2100 BAYNARD BLVD
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-3900
Mailing Address - Country:US
Mailing Address - Phone:302-225-9000
Mailing Address - Fax:302-225-9005
Practice Address - Street 1:4737 CONCORD PIKE
Practice Address - Street 2:RETRO FITNESS CENTER
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-1442
Practice Address - Country:US
Practice Address - Phone:302-225-9000
Practice Address - Fax:302-225-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty