Individual
DR. PAUL W. OTTO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
444 HOSPITAL WAY, STE 801, POCATELLO, ID 83201-2792
(208) 232-6214
(208) 233-3416
Mailing address
4582 W PORTNEUF RD, INKOM, ID 83245-1626
(208) 775-3262
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5603
ID
Other
Enumeration date
06/08/2005
Last updated
07/08/2007
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