Individual
CRAIG OTTING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(563) 663-1426
Mailing address
1119 N 8TH ST APT D, BOISE, ID 83702-4269
(563) 663-1426
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21029
IA
Other
Enumeration date
07/09/2009
Last updated
07/09/2009
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