Individual
AMY L WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
218 N BOLINGBROOK DR, BOLINGBROOK, IL 60440-2386
(630) 972-1541
(630) 972-1571
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216859223
MEDICARE RAILROAD
IL
Enumeration date
02/14/2011
Last updated
09/10/2012
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