Provider Demographics
NPI:1790238095
Name:JAMES D WARD DC PC
Entity Type:Organization
Organization Name:JAMES D WARD DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-610-9662
Mailing Address - Street 1:141 NW GREENWOOD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-2041
Mailing Address - Country:US
Mailing Address - Phone:541-610-9662
Mailing Address - Fax:541-388-2606
Practice Address - Street 1:141 NW GREENWOOD AVE STE 101
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2041
Practice Address - Country:US
Practice Address - Phone:541-610-9662
Practice Address - Fax:541-388-2606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2873111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty