Individual
MR. JOHNATHAN SEAMUS WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RT (R) CT
Contact information
Practice address
2223 DANIEL ROAD, PUEBLO, CO 81006
(360) 850-2739
Mailing address
P.O. BOX 432, SELIGMAN, AZ 86337
Taxonomy
Speciality
Code
Description
License number
State
2471C3401X
Computed Tomography Radiologic Technologist
CRT-12657
AZ
2471C3401X
Computed Tomography Radiologic Technologist
Primary
RHF64081
CA
2471C3401X
Computed Tomography Radiologic Technologist
RT60090679
WA
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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