Provider Demographics
NPI:1124643192
Name:WARD, BRITTANY (PTA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24584 BEAVER WAY
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-6840
Mailing Address - Country:US
Mailing Address - Phone:302-362-2925
Mailing Address - Fax:
Practice Address - Street 1:1632 SAVANNAH RD STE 8
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1659
Practice Address - Country:US
Practice Address - Phone:302-703-0800
Practice Address - Fax:302-313-4450
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ2-0001025225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant