Provider Demographics
NPI:1437468485
Name:OTR, INC.
Entity Type:Organization
Organization Name:OTR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-270-9650
Mailing Address - Street 1:920 GERMANTOWN PIKE, STE 20
Mailing Address - Street 2:PLYMOUTH GREENE OFFICE CAMPUS, STE 20
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462
Mailing Address - Country:US
Mailing Address - Phone:610-270-9650
Mailing Address - Fax:610-270-9685
Practice Address - Street 1:920 GERMANTOWN PIKE, STE 20
Practice Address - Street 2:PLYMOUTH GREENE OFFICE CAMPUS, STE 20
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462
Practice Address - Country:US
Practice Address - Phone:610-270-9650
Practice Address - Fax:610-270-9685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty