Individual
MR. MICHAEL ALAN WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, CSCS
Contact information
Practice address
309 S. MEDFORD DR., LUFKIN, TX 75901-5245
(936) 632-7656
(936) 634-1091
Mailing address
906 WILLOW OAK ST, DIBOLL, TX 75941-9773
(936) 829-4798
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT0945
TX
Other
Enumeration date
03/01/2006
Last updated
04/16/2009
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