Individual
DR. KAYE BRADLEY OTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
8100 PENN AVE S, SUITE 103, BLOOMINGTON, MN 55431-1360
(952) 303-5182
(952) 303-6528
Mailing address
8100 PENN AVE S, SUITE 103, BLOOMINGTON, MN 55431-1360
(612) 827-2651
(952) 303-6528
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
001763
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
765327100
—
MN
Enumeration date
07/30/2007
Last updated
09/27/2010
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