Individual
IVAN WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
812 AVIS DR, ANN ARBOR, MI 48108-9649
(800) 638-7564
(734) 622-0452
Mailing address
9578 SIMS DR, APT B9, EL PASO, TX 79925-7242
(734) 717-5739
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
04/09/2013
Last updated
04/09/2013
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