Individual
KRISTEN WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 S DAWN DR, MILLIKEN, CO 80543-8447
(970) 888-1216
Mailing address
1300 S DAWN DR, MILLIKEN, CO 80543-8447
(970) 888-1216
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
921183247
CO
347C00000X
Private Vehicle
921183247
CO
Other
Enumeration date
07/29/2018
Last updated
07/29/2018
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