Provider Demographics
NPI:1376791079
Name:WATSON, PAUL OSBORNE (OTR/LMT)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:OSBORNE
Last Name:WATSON
Suffix:
Gender:M
Credentials:OTR/LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1394 S US HIGHWAY 231 STE 1
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-4412
Mailing Address - Country:US
Mailing Address - Phone:334-618-1494
Mailing Address - Fax:
Practice Address - Street 1:1394 S US HIGHWAY 231 STE 1
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-4412
Practice Address - Country:US
Practice Address - Phone:334-443-1004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5880225X00000X
AL5456225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist