Individual
MACKENZIE NICOLE OTTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1908 N 14TH ST, PONCA CITY, OK 74601-2014
(580) 765-0518
Mailing address
1908 N 14TH ST, PONCA CITY, OK 74601-2014
(580) 765-0518
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3123477
TX
225100000X
Physical Therapist
Primary
5671
OK
Other
Enumeration date
05/22/2019
Last updated
01/28/2026
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