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General NPI Number Information
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NPI Number | 1134703267
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Entity Type | Individual
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Provider Name | AMY TERESA WATSON PT
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Gender | Female
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 4055 ROY WILSON WAY
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City | NEW PALESTINE
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State | IN
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Zip | 46163-8032
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Country | US
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Telephone | 317-866-7472
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Fax | 317-620-2865
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Provider Business Mailing Address
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Address Line | 7443 YORKSHIRE BLVD N
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City | INDIANAPOLIS
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State | IN
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Zip | 46229-4232
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Country | US
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Telephone | 317-670-3192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05004168A
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License Number State | IN
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