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NPI Code Detail

MEDICARE: GWYN MORGAN WATSON

MEDICARE: GWYN MORGAN WATSON
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 TherapistPT002677GA

General Provider Information

NPI Number : 1982165973
Entity Type Code : Individual
Provider Name (Legal Business Name) : GWYN MORGAN WATSON
Provider Business Mailing Address
First Line : 104 BELMONT DR
Second Line :
City : CANTON
State : GA
Zip : 30115-5543
Country : US
Telephone Number : 770-366-4366
Fax Number :
Provider Business Practice Location Address
First Line : 105 ARNOLD MILL RD
Second Line :
City : WOODSTOCK
State : GA
Zip : 30188-5027
Country : US
Telephone Number : 770-926-0015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2019
Last Update Date : 03/31/2019

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Directions to “ GWYN MORGAN WATSON ” Practice Location

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