MEDICARE: JOHN M WATSON CHIROPRACTIC INC

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	111N00000X	Chiropractor	DC20026	CA

General Provider Information

NPI Number	:	1760742183
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN M WATSON CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	800 QUINTANA RD
Second Line	:	SUITE B1
City	:	MORRO BAY
State	:	CA
Zip	:	93442-2300
Country	:	US
Telephone Number	:	805-772-6131
Fax Number	:	805-772-5281

Provider Business Practice Location Address
First Line	:	800 QUINTANA RD
Second Line	:	SUITE B1
City	:	MORRO BAY
State	:	CA
Zip	:	93442-2300
Country	:	US
Telephone Number	:	805-772-6131
Fax Number	:	805-772-5281

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	JOHN M WATSON
Credential	:	D.C.
Telephone Number	:	805-772-6131

Provider Enumeration Date	:	05/18/2012
Last Update Date	:	06/07/2017

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