Individual
LISA WATLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1470 UNION STREET, BROOKLYN, NY 11213
(718) 440-6261
Mailing address
1470 UNION ST, BROOKLYN, NY 11213-4446
(718) 440-6261
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002022
NY
Other
Enumeration date
11/08/2017
Last updated
07/21/2022
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