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General NPI Number Information
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NPI Number | 1487784062
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Entity Type | Individual
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Provider Name | ORLIN R WATSON ATC
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 52 SANFORD HIGH BLVD
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City | SANFORD
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State | ME
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Zip | 04073-3427
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Country | US
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Telephone | 207-651-9571
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Fax | 207-324-8080
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Provider Business Mailing Address
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Address Line | PO BOX 603A
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City | KENNEBUNKPORT
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State | ME
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Zip | 04046-1603
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Country | US
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Telephone | 207-251-1427
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT261
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License Number State | ME
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