MEDICARE: DAVID ANDREW WATSON PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT 02495	RI

General Provider Information

NPI Number	:	1427304476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ANDREW WATSON PT

Provider Business Mailing Address
First Line	:	535 CENTERVILLE RD
Second Line	:	SUITE 101
City	:	WARWICK
State	:	RI
Zip	:	02886-4486
Country	:	US
Telephone Number	:	401-737-4581
Fax Number	:	401-737-4811

Provider Business Practice Location Address
First Line	:	535 CENTERVILLE RD
Second Line	:	SUITE 101
City	:	WARWICK
State	:	RI
Zip	:	02886-4486
Country	:	US
Telephone Number	:	401-737-4581
Fax Number	:	401-737-4811

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2012
Last Update Date	:	07/27/2012

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