Provider Demographics
NPI:1437191020
Name:OTT, MARC (DC)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:OTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 ALAFAYA WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6234
Mailing Address - Country:US
Mailing Address - Phone:407-977-3434
Mailing Address - Fax:407-977-3433
Practice Address - Street 1:57 ALAFAYA WOODS BLVD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6234
Practice Address - Country:US
Practice Address - Phone:407-977-3434
Practice Address - Fax:407-977-3433
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9026111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor