Individual
BRENT MCKINLEY WATTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6015 POINTE WEST BLVD, COASTAL ORTHOPEDICS AND SPORTS MEDICINE, ATTN CREDENTIA, BRADENTON, FL 34209-5542
(941) 792-1404
(941) 296-7662
Mailing address
6015 POINTE WEST BLVD, COASTAL ORTHOPEDICS AND SPORTS MEDICINE, ATTN CREDENTIA, BRADENTON, FL 34209-5542
(941) 792-1404
(941) 296-7662
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA21781
FL
Other
Enumeration date
02/13/2012
Last updated
02/13/2012
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