Provider Demographics
NPI:1497043830
Name:WATKINS, CAROL (DC)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:
Last Name:WATKINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16630 W GREENWAY RD STE 321
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-2189
Mailing Address - Country:US
Mailing Address - Phone:602-529-5437
Mailing Address - Fax:
Practice Address - Street 1:16630 W GREENWAY RD STE 321
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-2189
Practice Address - Country:US
Practice Address - Phone:602-529-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8249111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor