Individual
MR. JEFFREY RICHARD OTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
N95W17707 SHADY LN, MENOMONEE FALLS, WI 53051-8012
(262) 415-0005
(262) 415-0005
Mailing address
N95W17707 SHADY LN, MENOMONEE FALLS, WI 53051-8012
(262) 415-0005
(262) 415-0005
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12967-040
WI
Other
Enumeration date
07/04/2011
Last updated
07/04/2011
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