Individual
JASON DEAN OTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3201 S LOUISE AVE, SIOUX FALLS, SD 57106-0704
(605) 362-2625
(605) 362-2636
Mailing address
1201 HYANNIS PORT LN, SIOUX FALLS, SD 57106-5467
(605) 362-6653
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4853
SD
Other
Enumeration date
07/01/2013
Last updated
07/01/2013
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