Healthcare Provider Details

I. General information

NPI: 1780882035
Provider Name (Legal Business Name): DEAN EDWARD WARD D.C,
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 5TH ST
ELKO NV
89801-3513
US

IV. Provider business mailing address

445 5TH ST
ELKO NV
89801-3513
US

V. Phone/Fax

Practice location:
  • Phone: 775-777-7066
  • Fax:
Mailing address:
  • Phone: 775-777-7066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberB-331
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: