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Individual

KELLY WARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
816 NW HILL ST, BEND, OR 97703-2925
(541) 598-5592
Mailing address
816 NW HILL ST, BEND, OR 97703-2925
(541) 598-5592

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12811
OR

Other

Enumeration date
09/04/2015
Last updated
09/04/2015
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