Otto, Michael E

Otto, Michael E is an individual health care provider with primary practice located at 1951 Bench Rd Suite E, Pocatello ID 83201-2073. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Otto, Michael E can be contacted via phone (208) 237-2080.

Contact Information

Primary practice address
1951 Bench Rd Suite E Pocatello ID 83201-2073
Phone: (208) 237-2080
Fax: (208) 237-1084
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X RPT186 Idaho

Profile Details

NPI number 1558324590
LBN Legal business name Otto, Michael E
Credentials Registered Physical Therapist (RPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Mar 8th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558324590 NPPES
Idaho MEDICAID 002682600
Idaho Other 000010020633
Idaho Other T1385

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