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General NPI Number Information
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NPI Number | 1184272601
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Entity Type | Individual
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Provider Name | ANDREA WATSON DC, MS, MBA
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Gender | Female
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 10420 S DECATUR BLVD STE 140
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City | LAS VEGAS
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State | NV
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Zip | 89141-8717
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Country | US
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Telephone | 702-332-3355
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Fax |
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Provider Business Mailing Address
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Address Line | 9611 STONEY MESA CT
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City | LAS VEGAS
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State | NV
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Zip | 89139-7403
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Country | US
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Telephone | 702-885-6166
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | B01510
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License Number State | NV
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