Individual
MRS. JAYNE ANN WATTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.
Contact information
Practice address
22215 TUPPER ST, SUITE B, WINFIELD, KS 67156-7326
(620) 705-1106
Mailing address
22215 TUPPER ST, SUITE B, WINFIELD, KS 67156-7326
(620) 705-1106
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CO2702
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO2702
CERTIFIED ORTHOTIST
KS
Enumeration date
07/11/2012
Last updated
07/11/2012
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