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Individual

LUKE A WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
10620 PARK RD, SUITE 200, CHARLOTTE, NC 28210-8472
(704) 667-2500
(704) 667-2507
Mailing address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
(704) 355-4370
(704) 355-4231

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1455
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
127M5
BCBS
NY
01
23315
MEDCOST
NY
01
293421
MAMSI
NC
05
7301857
NC
Enumeration date
08/01/2006
Last updated
07/08/2007
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