Healthcare Provider Details

I. General information

NPI: 1598797490
Provider Name (Legal Business Name): ERIK ALLEN WARD DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: KATHY KATUSHA MD

II. Dates (important events)

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

III. Provider practice location address

2955 S GLEBE RD SUITE E
ARLINGTON VA
22206-2730
US

IV. Provider business mailing address

2955 S GLEBE RD SUITE E
ARLINGTON VA
22206-2730
US

V. Phone/Fax

Practice location:
  • Phone: 703-535-8887
  • Fax: 703-535-7819
Mailing address:
  • Phone: 703-535-8887
  • Fax: 703-535-7819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number0104555796
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: