Provider Demographics
NPI:1518407402
Name:WATTS, KAYLA LOUISE (MSPO, CPO)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:LOUISE
Last Name:WATTS
Suffix:
Gender:F
Credentials:MSPO, CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 BRUNSWICK AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-2807
Mailing Address - Country:US
Mailing Address - Phone:704-348-4488
Mailing Address - Fax:
Practice Address - Street 1:1901 BRUNSWICK AVE STE 240
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2807
Practice Address - Country:US
Practice Address - Phone:704-348-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist