Individual
KELLY A OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SURGICAL ASSIST
Contact information
Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF ORTHOPAEDIC SURGERY, MILWAUKEE, WI 53226-3522
(414) 805-7410
(414) 890-5749
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF ORTHOPAEDIC SURGERY, MILWAUKEE, WI 53226-3522
(414) 805-7410
(414) 890-5749
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
183724
WI
Other
Enumeration date
11/20/2012
Last updated
11/20/2012
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