Provider Demographics
NPI:1720002835
Name:WARD, JOANNA M (PT, DPT, MS)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:M
Last Name:WARD
Suffix:
Gender:F
Credentials:PT, DPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 PEQUOSSETTE ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-2763
Mailing Address - Country:US
Mailing Address - Phone:617-216-1280
Mailing Address - Fax:
Practice Address - Street 1:247 W CENTRAL ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3714
Practice Address - Country:US
Practice Address - Phone:508-647-1633
Practice Address - Fax:508-647-1634
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16716174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA16716OtherPT LICENSE