Individual
KATHLEEN KAY OTTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
131 N POPLAR AVE, TEA, SD 57064-2152
(605) 498-2702
(605) 498-2702
Mailing address
131 N POPLAR AVE, TEA, SD 57064-2152
(605) 498-2700
(605) 498-2702
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
R018685
SD
Other
Enumeration date
05/03/2018
Last updated
05/03/2018
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