Healthcare Provider Details

I. General information

NPI: 1013502814
Provider Name (Legal Business Name): EMILY WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2021
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAHC VICENZA
APO AE
09630
US

IV. Provider business mailing address

CMR 427 BOX 531
APO AE
09630-0006
US

V. Phone/Fax

Practice location:
  • Phone: 339-619-7896
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305216042
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP13692
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: