Individual
MARCE J OTTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
102 W BEATON DR, WEST FARGO, ND 58078
(701) 205-4194
(701) 540-9044
Mailing address
102 W BEATON DR STE 105, WEST FARGO, ND 58078-2653
(701) 205-4194
(701) 540-9044
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10948
MN
225100000X
Physical Therapist
Primary
2150
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1460826
—
ND
Enumeration date
10/18/2017
Last updated
11/17/2022
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