Individual
BRANDON WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6638 S 57TH AVE, LAVEEN, AZ 85339-2254
(602) 346-0081
Mailing address
6638 S 57TH AVE, LAVEEN, AZ 85339-2254
(602) 346-0081
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107512
—
AZ
Enumeration date
05/13/2022
Last updated
05/13/2022
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