Healthcare Provider Details

I. General information

NPI: 1710631262
Provider Name (Legal Business Name): CHIROPRACTIC SPORTS DELAWARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 LAKESIDE DR
LEWES DE
19958-8979
US

IV. Provider business mailing address

269 LAKESIDE DR
LEWES DE
19958-8979
US

V. Phone/Fax

Practice location:
  • Phone: 302-250-6600
  • Fax:
Mailing address:
  • Phone: 302-250-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: PATRICK WINFIELD WARD
Title or Position: OWNER
Credential: D.C
Phone: 302-250-6600