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General NPI Number Information
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NPI Number | 1336437417
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Entity Type | Individual
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Provider Name | CHAD ALBERT OTTE O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2011
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 706 E WAYNE ST
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City | CELINA
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State | OH
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Zip | 45822-1380
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Country | US
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Telephone | 419-586-2909
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Fax | 419-586-8127
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Provider Business Mailing Address
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Address Line | 706 E WAYNE ST
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City | CELINA
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State | OH
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Zip | 45822-1380
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Country | US
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Telephone | 419-586-2909
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Fax | 419-586-8127
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6060
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License Number State | OH
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