Individual
RICHARD WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2400 SE COVENANT DR, GRIMES, IA 50111-4891
(515) 314-9353
Mailing address
2400 SE COVENANT DR, GRIMES, IA 50111-4891
(515) 314-9353
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
27-2674804
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37311
—
IA
Enumeration date
05/26/2010
Last updated
05/26/2010
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