Provider Demographics
NPI:1699798348
Name:WARD, JOYCE BERUS (DC)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:BERUS
Last Name:WARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:ANN
Other - Last Name:BERUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:23825 ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48134-9095
Mailing Address - Country:US
Mailing Address - Phone:737-676-6437
Mailing Address - Fax:
Practice Address - Street 1:27104 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-3537
Practice Address - Country:US
Practice Address - Phone:586-751-1977
Practice Address - Fax:586-751-1929
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2976633Medicaid
MI0H25080Medicare ID - Type Unspecified
MI2976633Medicaid