Individual
TRAVIS WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7970 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(250) 435-6413
Mailing address
7970 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
67024100A
IN
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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