Individual
KELSI WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 EMERALD DR, COLUMBUS, MS 39702-5526
(662) 244-8823
Mailing address
310 EMERALD DR, COLUMBUS, MS 39702-5526
(662) 244-8823
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
TA3228
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TA3228
—
MS
Enumeration date
02/08/2017
Last updated
02/08/2017
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