Individual
CICELY ANNETTE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2620 SATELLITE BLVD STE 100, DULUTH, GA 30096-1291
(404) 785-8619
Mailing address
3508 CASTLEHILL CT, TUCKER, GA 30084-3201
(678) 779-7806
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT007774
GA
Other
Enumeration date
04/08/2019
Last updated
04/08/2019
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