Individual
MR. ANDERSON JAY WARD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
1441 FLORIDA AVE, MODESTO, CA 95350-4405
(209) 576-3613
Mailing address
PO BOX 4138, MODESTO, CA 95352
(209) 576-3613
Taxonomy
Speciality
Code
Description
License number
State
246X00000X
Cardiovascular Specialist/Technologist
Primary
—
—
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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