Healthcare Provider Details

I. General information

NPI: 1760742183
Provider Name (Legal Business Name): JOHN M WATSON CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2012
Last Update Date: 06/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 QUINTANA RD SUITE B1
MORRO BAY CA
93442-2300
US

IV. Provider business mailing address

800 QUINTANA RD SUITE B1
MORRO BAY CA
93442-2300
US

V. Phone/Fax

Practice location:
  • Phone: 805-772-6131
  • Fax: 805-772-5281
Mailing address:
  • Phone: 805-772-6131
  • Fax: 805-772-5281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC20026
License Number StateCA

VIII. Authorized Official

Name: JOHN M WATSON
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 805-772-6131