Individual
MRS. JENNIFER MARIE WATKINS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LAT/ATC
Contact information
Practice address
11967 SELLERTON DR, FISHERS, IN 46037-7813
(317) 915-0899
Mailing address
11967 SELLERTON DR, FISHERS, IN 46037-7813
(317) 915-0899
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
36000772A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36000772A
INDIANA ATHLETIC TRAINER
IN
01
—
977530
NATA MEMBER #
IN
Enumeration date
09/14/2005
Last updated
07/08/2007
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