Healthcare Provider Details

I. General information

NPI: 1467399287
Provider Name (Legal Business Name): JONATHAN S WARD DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7849 TRAMWAY BLVD NE STE A
ALBUQUERQUE NM
87122-2529
US

IV. Provider business mailing address

7849 TRAMWAY BLVD NE STE A
ALBUQUERQUE NM
87122-2529
US

V. Phone/Fax

Practice location:
  • Phone: 505-895-9381
  • Fax: 505-213-2958
Mailing address:
  • Phone: 505-895-9381
  • Fax: 505-212-0786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-2026-0064
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: