Provider Demographics
NPI:1467104018
Name:TREMBUSH-OTTLEY, KARA (RPH)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:TREMBUSH-OTTLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:OTTLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:672 PETWORTH CT
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-9398
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7300 STATE ROUTE 161 E
Practice Address - Street 2:
Practice Address - City:PLAIN CITY
Practice Address - State:OH
Practice Address - Zip Code:43064-9276
Practice Address - Country:US
Practice Address - Phone:614-733-5012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-23127183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist