Provider Demographics
NPI:1548846454
Name:WARD, HOLLY (LAC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:HAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 118
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-0118
Mailing Address - Country:US
Mailing Address - Phone:740-477-3333
Mailing Address - Fax:
Practice Address - Street 1:420 LANCASTER PIKE
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-9272
Practice Address - Country:US
Practice Address - Phone:740-477-3333
Practice Address - Fax:740-477-1100
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65.000392171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist