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Individual

KRISTIN LARA OTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, MPT

Contact information

Practice address
3195 STILLWATER DR, PRESCOTT, AZ 86305-7171
(928) 771-8156
Mailing address
7516 N SUMMIT VIEW DR, PRESCOTT VALLEY, AZ 86314-3025
(928) 772-3925

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3938
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
391772
AHCCCS NUMBER
AZ
Enumeration date
02/03/2007
Last updated
07/08/2007
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