Individual
MS. ELIZABETH ANN OTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3290 N WELLNESS DR STE 240, HOLLAND, MI 49424-7261
(616) 395-9379
(616) 820-1457
Mailing address
3434 RIVERTOWN POINT CT SW, GRANDVILLE, MI 49418-3076
(616) 257-3344
(616) 457-1491
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004658
MI
363AM0700X
Medical Physician Assistant
PA0000001490
TN
Other
Enumeration date
07/03/2006
Last updated
09/13/2023
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