Individual
LYDIA WATTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9089 CLAIREMONT MESA BLVD SUITE 200, PREFERRED HEALTHCARE REGISTRY, SAN DIEGO, CA 92123
(800) 787-6787
Mailing address
1224 BERMUDA DR, LAGUNA BEACH, CA 92651-1904
(949) 484-3271
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2760
CA
Other
Enumeration date
12/11/2014
Last updated
12/11/2014
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