Individual
MRS. DIANE MARY OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
516 E GREEN BAY AVE, SAUKVILLE, WI 53080
(262) 284-9510
(262) 284-9511
Mailing address
516 E GREEN BAY AVE, RIVERVIEW PHYSICAL THERAPY & SPORTS MEDICINE S.C., SAUKVILLE, WI 53080
(262) 284-9510
(262) 284-9511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4345-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40377600
—
WI
Enumeration date
04/24/2007
Last updated
10/15/2008
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