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General NPI Number Information
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NPI Number | 1053966325
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Entity Type | Individual
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Provider Name | SYLVETTA M WARD LMT
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Gender | Female
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 301 BROOKSWOOD RD STE 11
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City | SHERWOOD
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State | AR
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Zip | 72120-4205
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Country | US
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Telephone | 501-551-5918
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Fax |
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Provider Business Mailing Address
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Address Line | 8223 FRONTIER RD
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City | LITTLE ROCK
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State | AR
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Zip | 72209-7106
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Country | US
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Telephone | 501-551-5918
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 3267
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License Number State | AR
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