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1194130179
MATHEW OTTO
MILWAUKEE, WI
NPI
1194130179
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WI 3324-23)
Enumeration Date
2014-06-27
Last Update Date
2023-10-03
Business Address
MATHEW OTTO
2900 W OKLAHOMA AVE
MILWAUKEE, WI 53215-4330
Phone number: 414-646-2550
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Mailing Address
MATHEW OTTO
PO BOX 735044
CHICAGO, IL 60673-5044
Phone number: 414-646-2550
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