Organization
WATERTOWN MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNETTA TRAYLOR (DIRECTOR)
(502) 596-6063
Entity
Organization
Contact information
Practice address
125 HOSPITAL DR, WATERTOWN, WI 53098-3303
(920) 262-4210
Mailing address
680 S 4TH ST # KH-3, LOUISVILLE, KY 40202-2407
(502) 596-6063
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
08/27/2015
Last updated
06/16/2025
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