| NPI | 1164567483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY T. OTTERMAN Owner 210-308-7473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 6583) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1170429) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |