Provider Demographics
NPI:1588833834
Name:WATTS, CHERIE SHARESE (DC)
Entity type:Individual
Prefix:
First Name:CHERIE
Middle Name:SHARESE
Last Name:WATTS
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 1:6771 NW DAFFODIL LN
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-1416
Mailing Address - Country:US
Mailing Address - Phone:305-522-7117
Mailing Address - Fax:
Practice Address - Street 1:6771 NW DAFFODIL LN
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-1416
Practice Address - Country:US
Practice Address - Phone:305-522-7117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8375111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor