Individual
MR. PETER PATRICK OTIENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE
Contact information
Practice address
131 JEFFORDS CT, PHOENIXVILLE, PA 19460-2842
(484) 401-6223
Mailing address
131 JEFFORDS CT, PHOENIXVILLE, PA 19460-2842
(484) 401-6223
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN320653
PA
Other
Enumeration date
01/31/2024
Last updated
01/31/2024
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