Provider Demographics
NPI:1922401140
Name:WARD, LONNIE MITCHELL (PT)
Entity Type:Individual
Prefix:MR
First Name:LONNIE
Middle Name:MITCHELL
Last Name:WARD
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Gender:M
Credentials:PT
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Mailing Address - Street 1:3377 RIVERBEND DR
Mailing Address - Street 2:OUTPATIENT THERAPY RIVERBEND PAVILION 3RD FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-8803
Mailing Address - Country:US
Mailing Address - Phone:541-222-6224
Mailing Address - Fax:541-431-9147
Practice Address - Street 1:3377 RIVERBEND DR
Practice Address - Street 2:OUTPATIENT THERAPY RIVERBEND PAVILION 3RD FLOOR
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-8803
Practice Address - Country:US
Practice Address - Phone:541-222-6224
Practice Address - Fax:541-431-9147
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
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Provider Licenses
StateLicense IDTaxonomies
OR38382251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic