Laurie Ottens

Individual provider Active NPI Physical Therapist · Weed, CA

NPI 1194377127 · NPPES record last updated Jul 10, 2019

Key facts

NPI
1194377127
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT14791 (CA)
Practice address
445 Park St
Weed, CA 96094-2332
Phone
(530) 938-4429
NPI assigned
Jul 10, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT14791CAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT14791 CA Yes

Addresses

Primary practice location

445 Park St
Weed, CA 96094-2332

Mailing address

317 W Alma St
Mount Shasta, CA 96067-2102
Phone (530) 859-0628

Other providers in Weed, CA

All providers in Weed, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.