Healthcare Provider Details

I. General information

NPI: 1033541453
Provider Name (Legal Business Name): BRUCE MICHAEL WARD JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2013
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 GLENWOOD AVE STE 200
RALEIGH NC
27603-1452
US

IV. Provider business mailing address

301 GLENWOOD AVE STE 200
RALEIGH NC
27603-1452
US

V. Phone/Fax

Practice location:
  • Phone: 919-829-5757
  • Fax: 919-829-5808
Mailing address:
  • Phone: 919-829-5757
  • Fax: 919-829-5808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4609
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: