Organization
OTR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA MARIE SULLIVAN (ADMINISTRATIVE DIRECTOR)
(610) 270-9650
Entity
Organization
Contact information
Practice address
920 GERMANTOWN PIKE, STE 20, PLYMOUTH GREENE OFFICE CAMPUS, STE 20, PLYMOUTH MEETING, PA 19462
(610) 270-9650
(610) 270-9685
Mailing address
920 GERMANTOWN PIKE, STE 20, PLYMOUTH GREENE OFFICE CAMPUS, STE 20, PLYMOUTH MEETING, PA 19462
(610) 270-9650
(610) 270-9685
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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