Provider Demographics
NPI:1750791273
Name:WATSON, ALICIA L (DC)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:L
Last Name:WATSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:227 RACHEL EVANS DR
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-8395
Mailing Address - Country:US
Mailing Address - Phone:864-921-4070
Mailing Address - Fax:864-599-7589
Practice Address - Street 1:1524 JOHN B WHITE SR BLVD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-3878
Practice Address - Country:US
Practice Address - Phone:864-921-4070
Practice Address - Fax:864-599-7589
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC3909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor