Provider Demographics
NPI:1912185778
Name:WATSONN ALTERNATIVE HEALTH & WEIGHT LOSS CENTER, INC.
Entity Type:Organization
Organization Name:WATSONN ALTERNATIVE HEALTH & WEIGHT LOSS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-623-3836
Mailing Address - Street 1:5536 STEWART ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-4304
Mailing Address - Country:US
Mailing Address - Phone:850-623-3836
Mailing Address - Fax:850-623-2201
Practice Address - Street 1:5536 STEWART ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-4304
Practice Address - Country:US
Practice Address - Phone:850-623-3836
Practice Address - Fax:850-623-2201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center