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Organization

STRIATIONS FITNESS SPORTS MEDICINE AND OCCUPATIONAL THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RANDALL SHAWN WATKINS SR. OTR/L, ATC, NSCA-CPT (PRESIDENT/OCCUPATIONAL THERAPIST)
(443) 850-1447
Entity
Organization

Contact information

Practice address
29 GREENMEADOW DR, TIMONIUM, MD 21093-3256
(410) 823-0870
Mailing address
7923 SAINT MONICA DR, DUNDALK, MD 21222-3536
(443) 850-1447

Taxonomy

Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
06421
MD

Other

Enumeration date
10/18/2010
Last updated
12/13/2010
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