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Individual

MRS. CHERYL MARIE ROERS OTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1405 MILWAUKEE DR, NEW HOLSTEIN, WI 53061-1430
(920) 898-5531
(920) 898-1581
Mailing address
521 RIVER TER, KIEL, WI 53042-1371
(920) 918-5769

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2515
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38587700
WI
Enumeration date
01/03/2006
Last updated
06/07/2013
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