Individual
SARA J OTTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
402 2ND AVE, CLARENCE, IA 52216-9754
(563) 452-3262
Mailing address
1357 LOGAN CT, NORTH LIBERTY, IA 52317-9115
(775) 450-5834
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03549
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03549
PHYSICAL THERAPY LISENCE
IA
Enumeration date
11/11/2012
Last updated
11/11/2012
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