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Individual

DR. ROSSIE EDWARD WATTS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
10060 TWO NOTCH RD, COLUMBIA, SC 29223-4396
(803) 788-1597
Mailing address
1 COOPERSMITH, COLUMBIA, SC 29229-9055

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
924
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04018
SPECTERA
SC
05
DO9248
SC
Enumeration date
06/01/2006
Last updated
07/08/2007
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