Healthcare Provider Details

I. General information

NPI: 1780646679
Provider Name (Legal Business Name): DANIEL TODD WARD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1713 MARION WALDO RD
MARION OH
43302-7427
US

IV. Provider business mailing address

1713 MARION WALDO RD
MARION OH
43302-7427
US

V. Phone/Fax

Practice location:
  • Phone: 740-387-2027
  • Fax: 740-382-8022
Mailing address:
  • Phone: 740-387-2027
  • Fax: 740-382-8022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE0003165
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: