Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1161909 | TX |
NPI | 1003149063 |
---|---|
Provider Name | Cheryl R Watson |
First Address | Wimberley, TX 78676-9362 |
Second Address | Wimberley, TX 78676-5311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2009 |
Last Update Date | 09/09/2009 |