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Individual

KRYSTEL DAWN OTTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS,ATC, LAT

Contact information

Practice address
3509 DEWEY ST, MANITOWOC, WI 54220-5813
(920) 686-5731
Mailing address
14104 ROSELAWN RD, VALDERS, WI 54245-9582
(920) 410-1656

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
883039
WI

Other

Enumeration date
03/28/2007
Last updated
02/19/2020
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