Provider Demographics
NPI:1659008316
Name:BOTTALICO, ERIKA KAINE (RDH, OMT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:KAINE
Last Name:BOTTALICO
Suffix:
Gender:F
Credentials:RDH, OMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 CALVERT TOWNE RD
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4100
Mailing Address - Country:US
Mailing Address - Phone:443-532-8331
Mailing Address - Fax:
Practice Address - Street 1:65 DUKE ST STE 107
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-6128
Practice Address - Country:US
Practice Address - Phone:301-337-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist