Provider Demographics
NPI:1538664792
Name:WARD, JONATHAN QUINN (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:QUINN
Last Name:WARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 SPEAKEASY LN
Mailing Address - Street 2:
Mailing Address - City:INMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29349-8337
Mailing Address - Country:US
Mailing Address - Phone:828-702-1678
Mailing Address - Fax:
Practice Address - Street 1:31 CROSS ST STE 266
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-6160
Practice Address - Country:US
Practice Address - Phone:828-702-1678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2021-09-24
Deactivation Date:2018-04-23
Deactivation Code:
Reactivation Date:2018-05-02
Provider Licenses
StateLicense IDTaxonomies
SC4510111N00000X, 111NN0400X
NC4882111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111N00000XChiropractic ProvidersChiropractor