Individual
MRS. LINDA B. OTTERBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
19525 W NORTH AVE, BROOKFIELD, WI 53045-4107
(262) 780-3810
(262) 780-3118
Mailing address
19525 W NORTH AVE, BROOKFIELD, WI 53045-4107
(262) 780-3810
(262) 780-3118
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
702-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40102000
—
WI
Enumeration date
05/09/2008
Last updated
09/18/2008
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