Healthcare Provider Details

I. General information

NPI: 1124643192
Provider Name (Legal Business Name): BRITTANY WARD PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1632 SAVANNAH RD STE 8
LEWES DE
19958-1659
US

IV. Provider business mailing address

24584 BEAVER WAY
GEORGETOWN DE
19947-6840
US

V. Phone/Fax

Practice location:
  • Phone: 302-703-0800
  • Fax: 302-313-4450
Mailing address:
  • Phone: 302-362-2925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberJ2-0001025
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: