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NPI Code Detail

MEDICARE: JUSTIN D WARD

MEDICARE: JUSTIN D WARD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225800000XRecreation Therapist

General Provider Information

NPI Number : 1437927753
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN D WARD
Provider Business Mailing Address
First Line : 2903 CANTERBURY BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46835-3205
Country : US
Telephone Number : 336-580-4582
Fax Number :
Provider Business Practice Location Address
First Line : 1400 AIRPORT NORTH OFFICE PARK STE D
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-6723
Country : US
Telephone Number : 133-658-0458
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2023
Last Update Date : 12/15/2023

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Directions to “ JUSTIN D WARD ” Practice Location

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