| NPI | 1003383027 |
|---|---|
| Doing Business As | WATERTOWN MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | JOHNETTA TRAYLOR AO 502-596-6063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2025-06-23 |