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MANDI OTT

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1700237153

Individual Registrant:
 MANDI  OTT 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
53 HIGHWAY 70 E STE B  GLENWOOD, AR 71943-8853 US
Tel: 870-356-4671  Fax: --

Contact information for business:
PO BOX 680  GLENWOOD, AR 71943-0680 US
Tel: --  Fax: --

Registration Information:
NPI: 1700237153
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
AR2740

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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