Individual
MICHAEL OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
730 W MARKET ST STE 2K, LIMA, OH 45801-4602
(419) 996-4011
(419) 996-4012
Mailing address
730 W MARKET ST STE 2K, LIMA, OH 45801-4602
(419) 996-4011
(419) 996-4012
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50001888
OH
Other
Enumeration date
10/19/2005
Last updated
11/05/2020
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