=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528144110
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RHONDA R GRETZ WARD DPM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 419 N CHESTNUT ST SUITE A
-----------------------------------------------------
City | SCOTTDALE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-887-2900
-----------------------------------------------------
Fax | 724-887-5477
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 33 419 N CHESTNUT ST
-----------------------------------------------------
City | SUITE A
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-887-2900
-----------------------------------------------------
Fax | 724-887-5477
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | SC004448R
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------