Individual
DR. ANDREW OTTAVIANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1515 HERBERT ST, SUITE 209, PORT ORANGE, FL 32129-6104
(386) 871-0153
Mailing address
1784 ARASH CIR, PORT ORANGE, FL 32128-7301
(386) 871-0153
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH9370
FL
Other
Enumeration date
06/25/2007
Last updated
07/08/2007
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