Individual
JEREMIAH OTTESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOTR/L
Contact information
Practice address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 417-6222
Mailing address
2301 25TH ST S, FARGO, ND 58103-6104
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
979
ND
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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