Individual
LEEANN OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
88 GRISWOLD ST, WALTON, NY 13856
(607) 865-5220
(607) 865-9211
Mailing address
42-66 NORTH ST., WALTON, NY 13856
(607) 865-5220
(607) 865-9211
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
659932
NY
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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