Healthcare Provider Details

I. General information

NPI: 1720002835
Provider Name (Legal Business Name): JOANNA M WARD PT, DPT, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 W CENTRAL ST
NATICK MA
01760-3714
US

IV. Provider business mailing address

48 PEQUOSSETTE ST
WATERTOWN MA
02472-2763
US

V. Phone/Fax

Practice location:
  • Phone: 508-647-1633
  • Fax: 508-647-1634
Mailing address:
  • Phone: 617-216-1280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number16716
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: