Provider Demographics
NPI:1679601462
Name:WATKEYS, JANICE (AT,C, CMT)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:WATKEYS
Suffix:
Gender:F
Credentials:AT,C, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31967 LAMAR ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2425
Mailing Address - Country:US
Mailing Address - Phone:248-442-1457
Mailing Address - Fax:
Practice Address - Street 1:31967 LAMAR ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336-2425
Practice Address - Country:US
Practice Address - Phone:248-442-1457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist