Individual
KEVIN P WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D-PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14088-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14088-24
WISCONSIN LICENSE
WI
Enumeration date
12/06/2017
Last updated
01/07/2021
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