Provider Demographics
NPI:1508226002
Name:WATSON, CHRISTOPHER (LAT, ATC, CES, PES)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:WATSON
Suffix:
Gender:M
Credentials:LAT, ATC, CES, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 TECH FARM RD
Mailing Address - Street 2:APT C-6
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-5462
Mailing Address - Country:US
Mailing Address - Phone:843-254-9202
Mailing Address - Fax:
Practice Address - Street 1:1408 TECH FARM RD
Practice Address - Street 2:APT C-6
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-5462
Practice Address - Country:US
Practice Address - Phone:843-254-9202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAATH.2004752255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer