MEDICARE: DR. DAVID JOSEPH WARDY D.C.

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
1	111N00000X	Chiropractor	10674	TX

General Provider Information

NPI Number	:	1710187810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JOSEPH WARDY D.C.

Provider Business Mailing Address
First Line	:	1035 BELVIDERE ST STE 250
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-2403
Country	:	US
Telephone Number	:	915-760-4700
Fax Number	:	915-760-8870

Provider Business Practice Location Address
First Line	:	1035 BELVIDERE ST STE 250
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-2403
Country	:	US
Telephone Number	:	915-760-4700
Fax Number	:	915-760-8870

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	07/18/2007

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