Provider Demographics
NPI:1336437417
Name:OTTE, CHAD ALBERT (OD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:ALBERT
Last Name:OTTE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 E WAYNE ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-1380
Mailing Address - Country:US
Mailing Address - Phone:419-586-2909
Mailing Address - Fax:419-586-8127
Practice Address - Street 1:706 E WAYNE ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-1380
Practice Address - Country:US
Practice Address - Phone:419-586-2909
Practice Address - Fax:419-586-8127
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6060152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist