Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 5501011018 | MI |
NPI | 1083117394 |
---|---|
Provider Name | Christina Marie Watson |
First Address | Rochester, MI 48307-6049 |
Second Address | Sterling Heights, MI 48313-1026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2018 |
Last Update Date | 15/04/2021 |