Individual
MICAH JOHN WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
97 BOCHICCHIO BLVD, COVINGTON TWP, PA 18444-6695
(570) 428-4287
Mailing address
1218 HUNTERS WOODS DR, EAST STROUDSBURG, PA 18301-7603
(570) 428-4287
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT005056
PA
Other
Enumeration date
12/22/2021
Last updated
12/22/2021
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