Individual
LATOYA LILLIAN WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
390 HENDERSON RD APT 7A, ROXBORO, NC 27573-4751
(336) 915-7030
Mailing address
111 BIRCHWOOD BAY, SAN ANTONIO, TX 78253-5241
(336) 915-7030
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
23590515
NC
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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