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NPI Profile for DEITRA A WATSON in FARGO, ND.
An individual skilled in the practice, making, use, and application to individual cases of an artificial substitute for a missing body part, such as an arm or leg, eye or tooth, used for functional or cosmetic reasons, or both
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Prosthetist |
224P00000X | 56 | Individual Certified Prosthetist | |
Massage Therapist |
225700000X |
| NPI Number | 1437345402 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 09/24/2007 | |
| Last updated | 12/20/2007 - About 18 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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DEITRA A WATSON
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DEITRA A WATSON