Provider Demographics
NPI:1902967052
Name:WARD, GARY CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:CHRISTOPHER
Last Name:WARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:G.
Other - Middle Name:CHRISTOPHER
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:8015 W EASTMAN PL
Mailing Address - Street 2:# 101
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-6342
Mailing Address - Country:US
Mailing Address - Phone:781-424-4243
Mailing Address - Fax:
Practice Address - Street 1:8015 W EASTMAN PL
Practice Address - Street 2:# 101
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-6342
Practice Address - Country:US
Practice Address - Phone:781-424-4243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45163Medicare ID - Type UnspecifiedMEDICARE