Provider Demographics
NPI:1386606382
Name:WATSON, ANTHONY WAYNE (BS,PT,SCS)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:WAYNE
Last Name:WATSON
Suffix:
Gender:M
Credentials:BS,PT,SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 S LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-2129
Mailing Address - Country:US
Mailing Address - Phone:513-524-4800
Mailing Address - Fax:513-523-8631
Practice Address - Street 1:504 S LOCUST ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-2129
Practice Address - Country:US
Practice Address - Phone:513-524-4800
Practice Address - Fax:513-523-8631
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH072432251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports