Individual
MATTHEW C OTTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3231 S NATIONAL AVE, SPRINGFIELD, MO 65807-7304
(417) 841-0116
(417) 888-5609
Mailing address
3231 S NATIONAL AVE, SPRINGFIELD, MO 65807-7304
(417) 841-0116
(417) 888-5609
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
200702331
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44-0552485
—
MO
Enumeration date
08/01/2012
Last updated
08/01/2012
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