Individual
JERRY B WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
8324 LA CAMILA RD NE, ALBUQUERQUE, NM 87110-2420
(505) 400-3963
Mailing address
8324 LA CAMILA RD NE, ALBUQUERQUE, NM 87110-2420
(505) 400-3963
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2347
NM
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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