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General NPI Number Information
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NPI Number | 1568231611
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Entity Type | Individual
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Provider Name | LANCE WARD DPT
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Gender | Male
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Dates
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Enumeration Date | 12/29/2023
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 861 OLD WINSTON RD
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City | KERNERSVILLE
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State | NC
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Zip | 27284-7140
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Country | US
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Telephone | 336-716-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 3621 N ELM ST APT 2D
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City | GREENSBORO
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State | NC
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Zip | 27455-2860
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Country | US
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Telephone |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | P22826
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | P22826
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License Number State | NC
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