Individual
ANDREA J WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4455 TELEGRAPH RD, SUITE 250, SAINT LOUIS, MO 63129-3354
(314) 416-4900
(314) 487-4663
Mailing address
1836 LACKLAND HILL PKWY, SAINT LOUIS, MO 63146-3572
(314) 872-1439
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2003011114
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003011114
MEDICAL LICENSE #
MO
Enumeration date
05/04/2006
Last updated
07/08/2007
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