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NPI Code Detail

MEDICARE: JUSTEIN WATERS

MEDICARE: JUSTEIN WATERS
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1588506570
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTEIN WATERS
Provider Business Mailing Address
First Line : 273 NEW CREEK HWY
Second Line :
City : KEYSER
State : WV
Zip : 26726-8216
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 273 NEW CREEK HWY
Second Line :
City : KEYSER
State : WV
Zip : 26726-8216
Country : US
Telephone Number : 304-788-7670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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Directions to “ JUSTEIN WATERS ” Practice Location

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