Individual
AMBER MARISA WATFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
10301 KANIS RD, LITTLE ROCK, AR 72205-6205
(501) 604-6913
Mailing address
329 CHANDLER RD, MALVERN, AR 72104-7609
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 280
AR
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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