Organization
DR. KAYE B. OTTER,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAYE BRADLEY OTTER D.C. (PRESIDENT)
(612) 827-2651
Entity
Organization
Contact information
Practice address
8100 PENN AVE S, STE 103, BLOOMINGTON, MN 55431-1360
(952) 303-5182
(952) 303-5182
Mailing address
8100 PENN AVE S, STE 103, BLOOMINGTON, MN 55431-1360
(952) 303-5182
(952) 303-5182
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
1763
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
765327100
—
MN
Enumeration date
04/10/2007
Last updated
09/27/2010
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