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General NPI Number Information
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NPI Number | 1235563545
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Entity Type | Individual
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Provider Name | CHRISTINA WARD PTA
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Gender | Female
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Dates
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Enumeration Date | 08/23/2013
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Last Update Date | 08/23/2013
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Provider Practice Location Address
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Address Line | 3890 COUNTY ROAD 25
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-7624
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Country | US
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Telephone | 870-321-0827
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24
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City | LEAD HILL
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State | AR
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Zip | 72644-0024
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Country | US
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Telephone | 870-321-0827
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA1745
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License Number State | AR
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