Individual
MR. CHARLES CARSON OTTERSTEDT IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-5000
Mailing address
9718 COLE MILL RD, NORTH CHESTERFIELD, VA 23237-3359
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0903003252
VA
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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