Provider Demographics
NPI:1578672176
Name:WARD, MONTY L (PT)
Entity type:Individual
Prefix:MR
First Name:MONTY
Middle Name:L
Last Name:WARD
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:9070 W CHEYENNE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8935
Mailing Address - Country:US
Mailing Address - Phone:702-818-5000
Mailing Address - Fax:702-818-5001
Practice Address - Street 1:12100 S YUKON AVE STE D
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-6662
Practice Address - Country:US
Practice Address - Phone:918-992-6247
Practice Address - Fax:539-867-7065
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2025-02-13
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK3848OtherLICENSE #
OK200132790AMedicaid
OK200132790AMedicaid