Individual
TYRON DEVOUR WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC/L
Contact information
Practice address
640 MARY MCLEOD BETHUNE BL, DAYTONA BEACH, FL 32114
(386) 481-2262
Mailing address
1250 WOODCREST DR, APT 2203, DAYTONA BEACH, FL 32114-5666
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL1802
FL
Other
Enumeration date
06/29/2006
Last updated
07/08/2007
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