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NPI Code Detail

MEDICARE: STEPHANIE WARD DPT

MEDICARE: STEPHANIE WARD DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2005001168MO

General Provider Information

NPI Number : 1023341914
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE WARD DPT
Provider Business Mailing Address
First Line : 13537 BARRETT PARKWAY DR
Second Line : SUITE 105
City : BALLWIN
State : MO
Zip : 63021-5899
Country : US
Telephone Number : 314-821-9126
Fax Number : 314-821-9142
Provider Business Practice Location Address
First Line : 951 WATERBURY FALLS DR
Second Line :
City : O FALLON
State : MO
Zip : 63368-2202
Country : US
Telephone Number : 636-336-0300
Fax Number : 636-336-0297
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2009
Last Update Date : 10/12/2009

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