MEDICARE: AMBER WATT

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	2278P1004X	Pulmonary Diagnostics Certified Respiratory Therapist	2004025921	MO

General Provider Information

NPI Number	:	1992063424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER WATT

Provider Business Mailing Address
First Line	:	4050 BROADWAY ST
Second Line	:	SUITE 220
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2615
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4050 BROADWAY ST
Second Line	:	SUITE 220
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2615
Country	:	US
Telephone Number	:	816-960-3510
Fax Number	:	877-832-0388

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

Provider Enumeration Date	:	05/03/2012
Last Update Date	:	05/03/2012

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Directions to “ AMBER WATT ” Practice Location

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