Individual
MRS. JAYNIE STUMBO WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
153 JOHNSON RD., MC DOWELL, KY 41647
(606) 377-2379
Mailing address
153 JOHNSON RD., MC DOWELL, KY 41647
(606) 377-2379
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
02024
KY
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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