# WATTS PRIMARY CARE PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225582687
- **Authorized official:** TALISHA WATTS DNP (CEO)
- **Authorized official phone:** (313) 465-9892

## Contact information

- **Practice address:** 34390 COUNTRY MEADOW RD, CHESTERFIELD, MI 48047-3161
- **Practice address phone:** (313) 465-9892
- **Mailing address:** 34390 COUNTRY MEADOW RD, CHESTERFIELD, MI 48047-3161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WG0000X | General Practice Registered Nurse | 4704246644 | MI | Yes |

## Other

- **Enumeration date:** 08/15/2016
- **Last updated:** 08/15/2016