Provider Demographics
NPI:1740922897
Name:WARD, PAYTEN ALLISON
Entity type:Individual
Prefix:
First Name:PAYTEN
Middle Name:ALLISON
Last Name:WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 REILLY RUN UNIT I
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-9073
Mailing Address - Country:US
Mailing Address - Phone:573-315-5141
Mailing Address - Fax:
Practice Address - Street 1:2020 REILLY RUN UNIT I
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-9073
Practice Address - Country:US
Practice Address - Phone:573-315-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-10
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care