Individual
MR. GERALD MICHAEL OTTENWALDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
KCPM
Contact information
Practice address
420 KENNEDY ST, BURLINGTON, KS 66839-1120
(620) 364-2606
Mailing address
625 SHERMAN ST, EMPORIA, KS 66801-2401
(620) 757-2661
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
KS
Other
Enumeration date
05/30/2018
Last updated
05/30/2018
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