Provider Demographics
NPI:1104167543
Name:WARD, DEBBIE L (LMT)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:L
Last Name:WARD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21838 E ALAMO LN
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3512
Mailing Address - Country:US
Mailing Address - Phone:720-231-2727
Mailing Address - Fax:
Practice Address - Street 1:21838 E ALAMO LN
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-3512
Practice Address - Country:US
Practice Address - Phone:720-231-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0014414171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor