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Individual

TRAVIS AARON WATERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
201 S NORTHPARK LN, JOPLIN, MO 64801-8426
(417) 623-4313
Mailing address
3035 N KENTWOOD AVE APT A207, SPRINGFIELD, MO 65803-4573
(417) 257-4588

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2021027452
MO

Other

Enumeration date
08/10/2021
Last updated
08/10/2021
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