Healthcare Provider Details

I. General information

NPI: 1104738350
Provider Name (Legal Business Name): WATSON PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 BROADWAY ST
VALLEY FALLS KS
66088-1303
US

IV. Provider business mailing address

305 WALNUT ST
VALLEY FALLS KS
66088-1229
US

V. Phone/Fax

Practice location:
  • Phone: 785-817-0807
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: BROCK WATSON
Title or Position: OWNER
Credential: DPT
Phone: 785-817-0807