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NPI Code Detail

MEDICARE: MRS. JESSICA PAIGE WATKINS RPT

MEDICARE: MRS. JESSICA PAIGE WATKINS RPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPTH4582AL

General Provider Information

NPI Number : 1255438719
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA PAIGE WATKINS RPT
Provider Business Mailing Address
First Line : 307 GRAND AVE NW
Second Line :
City : FORT PAYNE
State : AL
Zip : 35967-2109
Country : US
Telephone Number : 256-601-3015
Fax Number :
Provider Business Practice Location Address
First Line : 307 GRAND AVE NW
Second Line :
City : FORT PAYNE
State : AL
Zip : 35967-2109
Country : US
Telephone Number : 256-601-3015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2006
Last Update Date : 10/23/2024

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