Individual
DR. LEROY FRANK OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
127 SOUTH HIGH STREET, LAKE CITY, MN 55041-1637
(651) 345-3361
(651) 345-4049
Mailing address
127 SOUTH HIGH STREET, LAKE CITY, MN 55041-1637
(651) 345-3361
(651) 345-4049
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1381
WI
111N00000X
Chiropractor
Primary
1417
MN
111N00000X
Chiropractor
857CHI
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36065OT
BCBS
—
Enumeration date
12/05/2006
Last updated
07/08/2007
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