Provider Demographics
NPI:1336979384
Name:WARD, JARROD MATTHEW
Entity type:Individual
Prefix:
First Name:JARROD
Middle Name:MATTHEW
Last Name:WARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 TRINITY OAKS DR APT 328
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-2207
Mailing Address - Country:US
Mailing Address - Phone:662-931-2872
Mailing Address - Fax:
Practice Address - Street 1:6560 LAKE WORTH BLVD STE 500
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-3009
Practice Address - Country:US
Practice Address - Phone:817-790-9247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor