Individual
HALLEY M OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
240 MAPLE ST, WOODRUFF, WI 54568-9190
(715) 356-8870
(715) 356-8079
Mailing address
PO BOX 470, WOODRUFF, WI 54568-0470
(715) 356-8870
(715) 356-8079
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11949
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316207442
—
WI
Enumeration date
05/23/2012
Last updated
06/08/2016
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