Individual
CHRISTINA OTTERNESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1500 N OAKLAND AVE, BOLIVAR, MO 65613-3011
(417) 328-6036
(417) 328-6039
Mailing address
1500 N OAKLAND AVE, BOLIVAR, MO 65613-3099
(417) 328-6036
(417) 328-6039
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
2016014757
MO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2016014757
MO
Other
Enumeration date
06/24/2011
Last updated
05/05/2022
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