Healthcare Provider Details

I. General information

NPI: 1639021405
Provider Name (Legal Business Name): MS. BRITTANY S WATSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5105 GLENDALE AVE STE K
TOLEDO OH
43614-1842
US

IV. Provider business mailing address

5105 GLENDALE AVE STE K
TOLEDO OH
43614-1842
US

V. Phone/Fax

Practice location:
  • Phone: 419-847-0400
  • Fax: 419-382-0796
Mailing address:
  • Phone: 419-847-0400
  • Fax: 419-382-0796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: