Individual
KATELYN RENEE WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
101 BODIN DRIVE, BLDG 777, FAIRFIELD, CA 95688
(970) 580-1391
Mailing address
101 BODIN DRIVE, BLDG 777, FAIRFIELD, CA 95688
(707) 423-3825
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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