Individual
MICHELE A OTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 993-4168
Mailing address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 993-4168
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041242849
IL
Other
Enumeration date
02/24/2023
Last updated
02/24/2023
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