| Doctor Name: | MR. CEDRIC D WATTS |
| NPI Number: | 1245463769 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OTR/L, LMT |
| License Number: | 6052 |
| Business Practice Address: | 7500 Dollarway Rd Suite 301 White Hall, AR - 716023027 |
| Business Phone Number: | 8703299626 |
| Business Fax Number: | 8705345912 |
| Mailing Address: | 3902 S Fir St, PINE BLUFF |
| State: | AR |
| Postal Code: | 716036233 |
| Phone Number: | 8703299626 |
| Fax Number: | 8705345912 |
| NPI Enumeration Date: | 09/01/2009 |
| NPI Last Update Date: | 08/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225700000X |
| License Number: | 6052 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Massage Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |