Provider Demographics
NPI:1356319222
Name:WATTS, JAMES R (PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:WATTS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:P.O. BOX 843446
Mailing Address - Street 2:HEALTHTOUCH, LLC
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-3446
Mailing Address - Country:US
Mailing Address - Phone:803-227-8009
Mailing Address - Fax:803-227-8039
Practice Address - Street 1:MOORE ORTHOPAEDIC CLINIC, P.A.
Practice Address - Street 2:14 MEDICAL PARK SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-227-8009
Practice Address - Fax:803-227-8039
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC4318225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4318OtherPT LICENSE #