Individual
DR. KELLY OTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
9735 SW SHADY LN STE 303, TIGARD, OR 97223-5481
(503) 684-1273
(503) 684-1274
Mailing address
9735 SW SHADY LN STE 303, TIGARD, OR 97223-5481
(503) 684-1273
(503) 684-1274
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3885
OR
Other
Enumeration date
12/01/2008
Last updated
12/01/2008
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