Individual
MR. JACK LYNN OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
600 W FRANKLIN ST, SHELTON, WA 98584-3519
(360) 426-0718
(360) 426-2497
Mailing address
600 W FRANKLIN ST, SHELTON, WA 98584-3519
(360) 426-0718
(360) 426-2497
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00010648
WA
Other
Enumeration date
11/11/2010
Last updated
11/11/2010
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