MEDICARE: DANA WATTS LMT

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
1	225700000X	Massage Therapist	33.017429

General Provider Information

NPI Number	:	1558624809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA WATTS LMT

Provider Business Mailing Address
First Line	:	5282 TIMPSON RD
Second Line	:
City	:	CALEDONIA
State	:	OH
Zip	:	43314-9752
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1199 DELAWARE AVE STE 102C
Second Line	:
City	:	MARION
State	:	OH
Zip	:	43302-7462
Country	:	US
Telephone Number	:	419-569-4308
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2012
Last Update Date	:	02/05/2020

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Directions to “ DANA WATTS LMT” Practice Location

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