Individual
DEBRA ANN OTTENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
83 AIRWAYS PL, SOUTHAVEN, MS 38671-5885
(662) 349-8787
Mailing address
1453 BANBURY LN, HERNANDO, MS 38632-7503
(901) 497-8651
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4664
MS
Other
Enumeration date
09/02/2011
Last updated
09/02/2011
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