Individual
JACOB OTTATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2847 ALICE ST, WHITEHALL, MI 49461-9501
(231) 288-2063
Mailing address
2847 ALICE ST, WHITEHALL, MI 49461-9501
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
5502004879
MI
225200000X
Physical Therapy Assistant
Primary
PTA49016
CA
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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