Individual
JONATHAN CARL OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
306 STONER LOOP, SUITE 3, LAKESIDE, MT 59922-8600
(406) 844-0744
(406) 844-0759
Mailing address
148 E ARAPAHOE ST, THERMOPOLIS, WY 82443-2402
(307) 864-2146
(307) 864-2857
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11007
MT
Other
Enumeration date
04/05/2016
Last updated
05/18/2021
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