Provider Demographics
NPI:1306866256
Name:WATTS, ARMINDA L (PT)
Entity Type:Individual
Prefix:MS
First Name:ARMINDA
Middle Name:L
Last Name:WATTS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 GREENUP AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-1953
Mailing Address - Country:US
Mailing Address - Phone:800-609-0905
Mailing Address - Fax:800-609-0801
Practice Address - Street 1:711 S 3RD ST
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1854
Practice Address - Country:US
Practice Address - Phone:740-534-1156
Practice Address - Fax:740-534-1158
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH008508225100000X
WV2620225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2620OtherWV LICENSE
OH008508OtherOHIO LICENSE
WV3810010402Medicaid
OH008508OtherOHIO LICENSE
WV3810010402Medicaid