Provider Demographics
NPI:1841891546
Name:OTTERSTETTER, MARI (PT)
Entity type:Individual
Prefix:
First Name:MARI
Middle Name:
Last Name:OTTERSTETTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3945 WALNUT WOOD WAY
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7931
Mailing Address - Country:US
Mailing Address - Phone:330-329-7602
Mailing Address - Fax:
Practice Address - Street 1:3945 WALNUT WOOD WAY
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7931
Practice Address - Country:US
Practice Address - Phone:330-329-7602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-08
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty