Individual
MICHAEL T WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
129 WESTWOOD DR, BRENTWOOD, NY 11717-5715
(631) 404-0092
Mailing address
129 WESTWOOD DR, BRENTWOOD, NY 11717-5715
(631) 404-0092
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003789-1
NY
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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