Organization
OETTER FAMILY MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDELL LYNN OETTER M.D. (PHYSICIAN)
(219) 789-6704
Entity
Organization
Contact information
Practice address
401 WALL ST, VALPARAISO, IN 46383-2521
(219) 281-1729
Mailing address
401 WALL ST, SUITE B, VALPARAISO, IN 46383-2521
(219) 281-1729
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02001332A
IN
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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