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General NPI Number Information
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NPI Number | 1245508464
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Entity Type | Individual
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Provider Name | RICHARD OTTMER PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 2960 CAHILL MAIN
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City | FITCHBURG
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State | WI
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Zip | 53711
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Country | US
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Telephone | 608-273-4490
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Fax |
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Provider Business Mailing Address
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Address Line | W5440 SANDROCK RD
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City | NEW GLARUS
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State | WI
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Zip | 53574-9498
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16154-040
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2007026076
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License Number State | MO
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