Provider Demographics
NPI:1003792623
Name:WARD, OLIVIA
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2683 COUNTY ROAD 29
Mailing Address - Street 2:
Mailing Address - City:ALBERTA
Mailing Address - State:AL
Mailing Address - Zip Code:36720-2810
Mailing Address - Country:US
Mailing Address - Phone:678-427-5576
Mailing Address - Fax:
Practice Address - Street 1:87 PINE GROVE RD
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-2561
Practice Address - Country:US
Practice Address - Phone:800-949-8270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No174400000XOther Service ProvidersSpecialist