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Individual

DR. CAROL A. BOTTJER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
12220 STATE HIGHWAY 14 N, SUITE 3, CEDAR CREST, NM 87008-1640
(505) 286-0300
(505) 286-7754
Mailing address
PO BOX 1640, CEDAR CREST, NM 87008-1640
(505) 286-0300
(505) 286-7754

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1668DT
KY
152W00000X
Optometrist
Primary
661
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01259245
NM
Enumeration date
09/18/2007
Last updated
08/26/2024
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