Provider Demographics
NPI:1548380728
Name:WATKINS, BETH E (PT)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:E
Last Name:WATKINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12720 BENT OAK CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-7380
Mailing Address - Country:US
Mailing Address - Phone:317-345-9687
Mailing Address - Fax:317-823-8645
Practice Address - Street 1:12720 BENT OAK CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-7380
Practice Address - Country:US
Practice Address - Phone:317-345-9687
Practice Address - Fax:317-823-8645
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006252A2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics