Individual
THERESA ANN WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1102C YADKINVILLE RD, MOCKSVILLE, NC 27028-2037
(336) 751-5734
(336) 751-4968
Mailing address
720 SHEARERS RD, MOORESVILLE, NC 28115-9777
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2629
NC
Other
Enumeration date
04/02/2020
Last updated
07/28/2021
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