Individual
MRS. BRITTA TIDEMAND OTTOBONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, L-MT
Contact information
Practice address
4525 PROSPECT ST, WEST BLOOMFIELD, MI 48324-1275
(248) 681-3522
Mailing address
4525 PROSPECT ST, WEST BLOOMFIELD, MI 48324-1275
(248) 613-2279
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
MI
225700000X
Massage Therapist
—
MI
Other
Enumeration date
01/08/2007
Last updated
03/14/2016
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