Individual
TIWONA WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
238 ADLEY WAY STE D, GREENVILLE, SC 29607-6511
(864) 706-6933
Mailing address
238 ADLEY WAY STE D, GREENVILLE, SC 29607-6511
(864) 706-6933
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IHCP-1710
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05172014
—
SC
Enumeration date
04/22/2022
Last updated
04/22/2022
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