Otto, Khristine R
Otto, Khristine R is an sole proprietor health care provider with primary practice located at 611 N Lynndale Dr Ste 140, Appleton WI 54914-3041. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Otto, Khristine R can be contacted via phone (920) 915-8011.Contact Information
Primary practice address
611 N Lynndale Dr Ste 140
Appleton WI 54914-3041
Phone: (920) 915-8011
Fax: (855) 280-3658
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 3051-012 | Wisconsin |
Profile Details
| NPI number | 1902960750 |
|---|---|
| LBN Legal business name | Otto, Khristine R |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 19th, 2006 |
| Last updated | Oct 5th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902960750 | NPPES |
| Wisconsin | MEDICAID | 1902960750 |
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