Individual
JESSICA LEA OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1067 S HOVER ST STE E, PMB 187, LONGMONT, CO 80501-7903
(828) 275-7114
Mailing address
1067 S HOVER ST STE E, PMB 187, LONGMONT, CO 80501-7903
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
13212
CO
225200000X
Physical Therapy Assistant
A5092
NC
Other
Enumeration date
10/21/2013
Last updated
02/04/2014
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