Individual
AMANDA N WATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 726-8575
Mailing address
55 FRUIT ST BLDG SUITE3B, BOSTON, MA 02114-2696
(617) 726-8575
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA8588
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
01/04/2021
Last updated
02/28/2024
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