Individual
MS. MARTHA LAURIE WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
117 S 11TH AVE, LAUREL, MS 39440-4312
(601) 425-3033
(601) 422-0431
Mailing address
PO BOX 4361, LAUREL, MS 39441-4361
(601) 425-3033
(601) 422-0431
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
818867
MS
Other
Enumeration date
02/09/2011
Last updated
02/09/2011
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