Individual
BRIAN BOTTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2109
Mailing address
1825 LOGAN AVE, WATERLOO, IA 50703-1916
(319) 235-3941
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO-06298
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2020
Last updated
08/10/2023
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