Individual
JUSTIN WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
507 W OMAHA AVE, NORFOLK, NE 68701-6244
(405) 410-6402
Mailing address
507 W OMAHA AVE, NORFOLK, NE 68701-6244
(405) 410-6402
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
54690-25
NE
Other
Enumeration date
12/26/2025
Last updated
12/26/2025
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