Provider Demographics
NPI:1497045231
Name:WATSON, SJOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:SJOHN
Middle Name:
Last Name:WATSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9060 ANDERMATT DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9644
Mailing Address - Country:US
Mailing Address - Phone:402-261-9473
Mailing Address - Fax:
Practice Address - Street 1:9060 ANDERMATT DR
Practice Address - Street 2:SUITE 107
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9644
Practice Address - Country:US
Practice Address - Phone:402-261-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1652111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist